Overnight closed-loop insulin delivery in young people with type 1 diabetes: a free-living, randomized clinical trial.
Overnight closed-loop insulin delivery in young people with type 1 diabetes: a free-living, randomized clinical trial.
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DOI：
10.2337/dc13-2644
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发表时间：
2014
期刊：
影响因子：
16.2
通讯作者：
Dunger DB
中科院分区：
文献类型：
--
作者：
Hovorka R;Elleri D;Thabit H;Allen JM;Leelarathna L;El-Khairi R;Kumareswaran K;Caldwell K;Calhoun P;Kollman C;Murphy HR;Acerini CL;Wilinska ME;Nodale M;Dunger DB
评价夜间闭环胰岛素输注在自由生活的1型糖尿病青年中的可行性、安全性和有效性。16名接受胰岛素泵治疗的12-18岁1型糖尿病青少年在家中对夜间闭环进行了评价。在3周的时间内，通过闭环系统指导过夜胰岛素输送，并在另一个3周的时间内应用传感器增强治疗。干预的顺序是随机的。主要终点为2300 - 0700 h调整探头葡萄糖在3.9 - 8.0 mmol/L之间的时间。在269个夜晚（80%）持续应用闭环至少4小时;在282个对照夜晚（84%）收集传感器数据至少4小时。闭环使葡萄糖处于目标水平的时间增加了15%（四分位数范围-9至43; P < 0.001）。平均过夜葡萄糖平均降低14（SD 58）mg/dL（P < 0.001）。两组中血糖<70 mg/dL的时间较短，但在闭环期间，血糖<63 mg/dL至少20分钟的夜间发生率较低（10 vs. 17%; P = 0.01）。尽管每日胰岛素总剂量较低，中位数为2.3（四分位数范围-4.7至9.3）单位（P = 0.009），但在闭环期间，24小时总体血糖平均降低9（SD 41）mg/dL（P = 0.006）。1型糖尿病青少年患者在无监督的家庭使用过夜闭环是安全可行的。白天和夜间的血糖控制得到改善，夜间低血糖发作次数减少。
To evaluate feasibility, safety, and efficacy of overnight closed-loop insulin delivery in free-living youth with type 1 diabetes. Overnight closed loop was evaluated at home by 16 pump-treated adolescents with type 1 diabetes aged 12–18 years. Over a 3-week period, overnight insulin delivery was directed by a closed-loop system, and on another 3-week period sensor-augmented therapy was applied. The order of interventions was random. The primary end point was time when adjusted sensor glucose was between 3.9 and 8.0 mmol/L from 2300 to 0700 h. Closed loop was constantly applied over at least 4 h on 269 nights (80%); sensor data were collected over at least 4 h on 282 control nights (84%). Closed loop increased time spent with glucose in target by a median 15% (interquartile range −9 to 43; P < 0.001). Mean overnight glucose was reduced by a mean 14 (SD 58) mg/dL (P < 0.001). Time when glucose was <70 mg/dL was low in both groups, but nights with glucose <63 mg/dL for at least 20 min were less frequent during closed loop (10 vs. 17%; P = 0.01). Despite lower total daily insulin doses by a median 2.3 (interquartile range −4.7 to 9.3) units (P = 0.009), overall 24-h glucose was reduced by a mean 9 (SD 41) mg/dL (P = 0.006) during closed loop. Unsupervised home use of overnight closed loop in adolescents with type 1 diabetes is safe and feasible. Glucose control was improved during the day and night with fewer episodes of nocturnal hypoglycemia.
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影响因子：
16.2
作者：
Elleri D;Allen JM;Kumareswaran K;Leelarathna L;Nodale M;Caldwell K;Cheng P;Kollman C;Haidar A;Murphy HR;Wilinska ME;Acerini CL;Dunger DB;Hovorka R
通讯作者：
Hovorka R
影响因子：
158.5
作者：
Pickup, John C.
通讯作者：
Pickup, John C.
影响因子：
16.2
作者：
Kovatchev BP;Renard E;Cobelli C;Zisser HC;Keith-Hynes P;Anderson SM;Brown SA;Chernavvsky DR;Breton MD;Farret A;Pelletier MJ;Place J;Bruttomesso D;Del Favero S;Visentin R;Filippi A;Scotton R;Avogaro A;Doyle FJ 3rd
通讯作者：
Doyle FJ 3rd
影响因子：
3.4
作者：
Slover, Robert H.;Welsh, John B.;Tamborlane, William V.
通讯作者：
Tamborlane, William V.
影响因子：
16.2
作者：
Dauber A;Corcia L;Safer J;Agus MS;Einis S;Steil GM
通讯作者：
Steil GM