Exploration of the Performance of a Hybrid Closed Loop Insulin Delivery Algorithm That Includes Insulin Delivery Limits Designed to Protect Against Hypoglycemia.
Exploration of the Performance of a Hybrid Closed Loop Insulin Delivery Algorithm That Includes Insulin Delivery Limits Designed to Protect Against Hypoglycemia.
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DOI：
10.1177/1932296816668876
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发表时间：
2017-01-01
影响因子：
5
通讯作者：
Jones, Timothy
中科院分区：
文献类型：
--
作者：
de Bock, Martin;Dart, Julie;Jones, Timothy
背景：低血糖仍然是闭环胰岛素输注的风险，特别是在运动后或葡萄糖传感器不准确时。本研究的目的是测试是否算法，包括胰岛素输送的限制是有效的，在保护低血糖症，在这种情况下.METHODS：一项观察性研究，对8名参与者与1型糖尿病进行，其中混合闭环系统（HCL）（Medtronic 670G）受到低血糖刺激的挑战：运动和过度读取葡萄糖传感器。在HCL胰岛素输注期间，未发生过夜或运动诱导的低血糖。所有白天的低血糖是由于餐后推注胰岛素在那些参与者具有更积极的碳水化合物factor.CONCLUSION：HCL系统依赖于准确的碳水化合物比例和碳水化合物计数，以避免低血糖。针对中度运动和过度读取葡萄糖传感器测试的算法在避免低血糖方面表现良好。算法改进继续为长期门诊试验做准备。
BACKGROUND: Hypoglycemia remains a risk for closed loop insulin delivery particularly following exercise or if the glucose sensor is inaccurate. The aim of this study was to test whether an algorithm that includes a limit to insulin delivery is effective at protecting against hypoglycemia under those circumstances.METHODS: An observational study on 8 participants with type 1 diabetes was conducted, where a hybrid closed loop system (HCL) (Medtronic 670G) was challenged with hypoglycemic stimuli: exercise and an overreading glucose sensor.RESULTS: There was no overnight or exercise-induced hypoglycemia during HCL insulin delivery. All daytime hypoglycemia was attributable to postmeal bolused insulin in those participants with a more aggressive carbohydrate factor.CONCLUSION: HCL systems rely on accurate carbohydrate ratios and carbohydrate counting to avoid hypoglycemia. The algorithm that was tested against moderate exercise and an overreading glucose sensor performed well in terms of hypoglycemia avoidance. Algorithm refinement continues in preparation for long-term outpatient trials.