Feasibility of Overnight Closed-Loop Control Based on Hourly Blood Glucose Measurements
Feasibility of Overnight Closed-Loop Control Based on Hourly Blood Glucose Measurements
复制标题
基于每小时血糖测量的夜间闭环控制的可行性
DOI：
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发表时间：
2012
影响因子：
5
通讯作者：
G. Freckmann
中科院分区：
文献类型：
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作者：
C. Patte;Stefan Pleus;Paul J. Galley;S. Weinert;C. Haug;G. Freckmann
简介：安全有效的闭环控制（人工胰腺）是胰岛素输送的最终目标。在本研究中，我们检查了用于过夜时间段的闭环控制算法的性能，以安全地实现早餐前血糖（BG）浓度的窄目标范围。主要目标是在重复过夜实验期间比较算法控制的质量。材料与方法：23例1型糖尿病受试者在研究中心的3次访视中每次进行2次过夜实验，共进行138次过夜实验。第一天晚上，对受试者进行胰岛素治疗;第二天晚上，通过基于皮下连续血糖测量（包括进餐控制）的算法输注胰岛素，直至午夜。根据第一晚和第二晚的每小时静脉BG测量值，在午夜至上午6点之间应用过夜闭环控制。结果如下：目标范围（90-150 mg/dl）内的BG值数量从第一个晚上的52.9%（414次测量中的219次）增加到第二个晚上的72.2%（414次测量中的299次）（p <0.001，X2检验）。低血糖干预的发生率从14次口服葡萄糖干预（最后一次发生在第一晚凌晨2：36）减少到第二晚凌晨1：02的1次干预（p <0.001，X2检验）。结论：夜间控制器的性能得到改善时，优化的初始控制，这是建议在第二个晚上更好的代谢控制。充足的控制器运行时间对于实现良好的夜间控制似乎是重要的。此外，研究结果表明，每小时BG数据足以使测试的闭环控制算法实现适当的血糖控制。
Introduction: Safe and effective closed-loop control (artificial pancreas) is the ultimate goal of insulin delivery. In this study, we examined the performance of a closed-loop control algorithm used for the overnight time period to safely achieve a narrow target range of blood glucose (BG) concentrations prior to breakfast. The primary goal was to compare the quality of algorithm control during repeated overnight experiments. Materials and Methods: Twenty-three subjects with type 1 diabetes performed 2 overnight experiments on each of three visits at the study site, resulting in 138 overnight experiments. On the first evening, the subject's insulin therapy was applied; on the second, the insulin was delivered by an algorithm based on subcutaneous continuous glucose measurements (including meal control) until midnight. Overnight closed-loop control was applied between midnight and 6 a.m. based on hourly venous BG measurements during the first and second nights. Results: The number of BG values within the target range (90–150 mg/dl) increased from 52.9% (219 out of 414 measurements) during the first nights to 72.2% (299 out of 414 measurements) during the second nights (p < .001, X 2-test). The occurrence of hypoglycemia interventions was reduced from 14 oral glucose interventions, the latest occurring at 2:36 a.m. during the first nights, to 1 intervention occurring at 1:02 a.m. during the second nights (p < .001, X 2-test). Conclusions: Overnight controller performance improved when optimized initial control was given; this was suggested by the better metabolic control during the second night. Adequate controller run-in time seems to be important for achieving good overnight control. In addition, the findings demonstrate that hourly BG data are sufficient for the closed-loop control algorithm tested to achieve appropriate glycemic control.
影响因子：
5.4
作者：
Cengiz E;Swan KL;Tamborlane WV;Steil GM;Steffen AT;Weinzimer SA
通讯作者：
Weinzimer SA
影响因子：
158.5
作者：
Nathan, DM;Cleary, PA;Zinman, B
通讯作者：
Zinman, B