Feasibility Study of Automated Overnight Closed-Loop Glucose Control Under MD-Logic Artificial Pancreas in Patients with Type 1 Diabetes: The DREAM Project.

Abstract Background: Artificial pancreas systems may offer a potential major impact on the normalization of metabolic control and preventing hypoglycemic events. This study aims to establish near-normal overnight glucose control and reduce the risk of nocturnal hypoglycemia using the MD-Logic Artifi...

Descripción completa

Detalles Bibliográficos
Publicado en:Diabetes Technology & Therapeutics Vol. 14; no. 8; pp. 728 - 736
Autores principales: Nimri R, Atlas E, Ajzensztejn M, Miller S, Oron T, Phillip M
Formato: research Journal Article
Publicado: Mary Ann Liebert, Inc. 2012 Aug
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=108066625&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 108066625
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        15209156
        N3C
      jtl: Diabetes Technology & Therapeutics
      issn: 15209156
      maglogo: N
    pubinfo:
      dt: 2012 Aug
      vid: 14
      iid: 8
      pid: 1365
      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
    artinfo:
      ui:
        108066625
        108066625
        2011634994
        10.1089/dia.2012.0004
        NLM22853723
        108066625
      ppf: 728
      ppct: 8
      formats:
      tig:
        atl: Feasibility Study of Automated Overnight Closed-Loop Glucose Control Under MD-Logic Artificial Pancreas in Patients with Type 1 Diabetes: The DREAM Project.
      aug:
        au:
          Nimri R
          Atlas E
          Ajzensztejn M
          Miller S
          Oron T
          Phillip M
        affil: 1 The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, The National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel , Petah Tikva, Israel .
      sug:
        subj:
          Algorithms
          Blood Glucose Metabolism
          Diabetes Mellitus, Type 1 Blood
          Glycated Hemoglobin Metabolism
          Hypoglycemic Agents Administration and Dosage
          Insulin Administration and Dosage
          Artificial Organs
          Blood Glucose Self-Monitoring
          Circadian Rhythm
          Diabetes Mellitus, Type 1 Drug Therapy
          Equipment Design
          Pilot Studies
          Female
          Human
          Insulin Infusion Systems
          Male
          Monitoring, Physiologic
          Young Adult
          Female
          Male
      ab: Abstract Background: Artificial pancreas systems may offer a potential major impact on the normalization of metabolic control and preventing hypoglycemic events. This study aims to establish near-normal overnight glucose control and reduce the risk of nocturnal hypoglycemia using the MD-Logic Artificial Pancreas (MDLAP), an algorithm that was developed by our research group. This inpatient feasibility study is the first step towards implementing an overnight closed-loop MDLAP system at the patient's home. Subjects and Methods: Seven patients with type 1 diabetes (three adolescents and four adults; mean±SD age, 20.6±4.7 years; duration of diabetes, 9.6±2.6 years; body mass index, 24.3±3.9 kg/m(2); and glycated hemoglobin, 7.8±0.8%) participated in a total of 14 closed-loop overnight sessions. Each participant underwent two closed-loop inpatient sessions starting at dinner alone and at dinner following exercise. The closed-loop inpatient sessions were compared with data derived from nights spent at home with an open-loop system in a similar scenario to the study protocol. Results: The mean percentage of time spent in the near normal glucose range of 63-140 mg/dL was 83±16%, and the median (interquartile range) was 85% (78-92%) for the overnight closed-loop sessions compared with 34±31% and 27% (6-57%) in the homecare open-loop setting, respectively. During the overnight closed-loop sessions at dinner alone 92±9% of the sensor values ranged within target range, compared with 73±19% for the sessions following exercise (P=0.03). No hypoglycemic (<63 mg/dL) events occurred during the closed-loop sessions. Conclusion: Closed-loop insulin delivery under MDLAP is a feasible and safe solution to control overnight glycemia.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N