Multicenter outpatient dinner/overnight reduction of hypoglycemia and increased time of glucose in target with a wearable artificial pancreas using modular model predictive control in adults with type 1 diabetes - Université de Montpellier Accéder directement au contenu
Article Dans Une Revue Diabetes, Obesity and Metabolism Année : 2015

Multicenter outpatient dinner/overnight reduction of hypoglycemia and increased time of glucose in target with a wearable artificial pancreas using modular model predictive control in adults with type 1 diabetes

S. del Favero
  • Fonction : Auteur
J. Kropff
  • Fonction : Auteur
M. Messori
  • Fonction : Auteur
P. Keith-Hynes
  • Fonction : Auteur
R. Visentin
  • Fonction : Auteur
M. Monaro
  • Fonction : Auteur
S. Galasso
  • Fonction : Auteur
F. Boscari
  • Fonction : Auteur
C. Toffanin
  • Fonction : Auteur
F. Di Palma
  • Fonction : Auteur
G. Lanzola
  • Fonction : Auteur
S. Scarpellini
  • Fonction : Auteur
B. Kovatchev
  • Fonction : Auteur
A. Avogaro
  • Fonction : Auteur
D. Bruttomesso
  • Fonction : Auteur
L. Magni
  • Fonction : Auteur
J.H. Devries
  • Fonction : Auteur
C. Cobelli
  • Fonction : Auteur
Ap@home Consortium
  • Fonction : Auteur

Résumé

AIMS:To test in an outpatient setting the safety and efficacy of continuous subcutaneous insulin infusion (CSII) driven by a modular model predictive control (MMPC) algorithm informed by continuous glucose monitoring (CGM) measurement.METHODS:13 patients affected by type 1 diabetes participated to a non-randomized outpatient 42-h experiment that included two evening meals and overnight periods (in short, dinner & night periods). CSII was patient-driven during dinner & night period 1 and MMPC-driven during dinner&night period 2. The study was conducted in hotels, where patients could move around freely. A CGM system (G4 Platinum; Dexcom Inc., San Diego, CA, USA) and insulin pump (AccuChek Combo; Roche Diagnostics, Mannheim, Germany) were connected wirelessly to a smartphone-based platform (DiAs, Diabetes Assistant; University of Virginia, Charlottesville, VA, USA) during both periods.RESULTS:A significantly lower percentage of time spent with glucose levels <3.9 mmol/l was achieved in period 2 compared with period 1: 1.96 ± 4.56% vs 12.76 ± 15.84% (mean ± standard deviation, p < 0.01), together with a greater percentage of time spent in the 3.9-10 mmol/l target range: 83.56 ± 14.02% vs 62.43 ± 29.03% (p = 0.04). In addition, restricting the analysis to the overnight phases, a lower percentage of time spent with glucose levels <3.9 mmol/l (1.92 ± 4.89% vs 12.7 ± 19.75%; p = 0.03) was combined with a greater percentage of time spent in 3.9-10 mmol/l target range in period 2 compared with period 1 (92.16 ± 8.03% vs 63.97 ± 2.73%; p = 0.01). Average glucose levels were similar during both periods.CONCLUSIONS:The results suggest that MMPC managed by a wearable system is safe and effective during evening meal and overnight. Its sustained use during this period is currently being tested in an ongoing randomized 2-month study.

Dates et versions

hal-02135535 , version 1 (21-05-2019)

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S. del Favero, Jérôme Place, J. Kropff, M. Messori, P. Keith-Hynes, et al.. Multicenter outpatient dinner/overnight reduction of hypoglycemia and increased time of glucose in target with a wearable artificial pancreas using modular model predictive control in adults with type 1 diabetes. Diabetes, Obesity and Metabolism, 2015, 17 (5), pp.468-476. ⟨10.1111/dom.12440⟩. ⟨hal-02135535⟩
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