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- Title
Real-Time Hypoglycemia Prediction Suite Using Continuous Glucose Monitoring.
- Authors
Dassau, Eyal; Cameron, Fraser; Lee, Hyunjin; Bequette, B. Wayne; Zisser, Howard; Jovanovič, Lois; Chase, H. Peter; Wilson, Darrell M.; Buckingham, Bruce A.; Doyle III, Francis J.
- Abstract
OBJECTIVE -- The purpose of this study was to develop an advanced algorithm that detects pending hypoglycemia and then suspends basal insulin delivery. This approach can provide a solution to the problem of nocturnal hypoglycemia, a major concern of patients with diabetes. RESEARCH DESIGN AND METHODS-- This real-time hypoglycemia prediction algorithm (HPA) combines five individual algorithms, all based on continuous glucose monitoring 1-min data. A predictive alarm is issued by a voting algorithm when a hypoglycemic event is predicted to occur in the next 35 min. The HPA system was developed using data derived from 21 Navigator studies that assessed Navigator function over 24 h in children with type 1 diabetes. We confirmed the function of the HPA using a separate dataset from 22 admissions of type 1 diabetic subjects. During these admissions, hypoglycemia was induced by gradual increases in the basal insulin infusion rate up to 180% from the subject's own baseline infusion rate. RESULTS -- Using a prediction horizon of 35 min, a glucose threshold of 80 mg/dl, and a voting threshold of three of five algorithms to predict hypoglycemia (defined as a FreeStyle plasma glucose readings <60 mg/dl), the HPA predicted 91% of the hypoglycemic events. When four of five algorithms were required to be positive, then 82% of the events were predicted. CONCLUSIONS-- The HPA will enable automated insulin-pump suspension in response to a pending event that has been detected prior to severe immediate Complications.
- Subjects
ALGORITHMS; HYPOGLYCEMIA; INSULIN therapy; GLUCOSE; DIABETES in children
- Publication
Diabetes Care, 2010, Vol 33, Issue 6, p1249
- ISSN
0149-5992
- Publication type
Article
- DOI
10.2337/dc09-1487