We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Autonomous and continuous adaptation of a bihormonal bionic pancreas in adults and adolescents with type 1 diabetes.
- Authors
El-Khatib, Firas H; Russell, Steven J; Magyar, Kendra L; Sinha, Manasi; McKeon, Katherine; Nathan, David M; Damiano, Edward R
- Abstract
<bold>Context: </bold>A challenge for automated glycemic control in type 1 diabetes (T1D) is the large variation in insulin needs between individuals and within individuals at different times in their lives.<bold>Objectives: </bold>The objectives of the study was to test the ability of a third-generation bihormonal bionic pancreas algorithm, initialized with only subject weight; to adapt automatically to the different insulin needs of adults and adolescents; and to evaluate the impact of optional, automatically adaptive meal-priming boluses.<bold>Design: </bold>This was a randomized controlled trial.<bold>Setting: </bold>The study was conducted at an inpatient clinical research center.<bold>Patients: </bold>Twelve adults and 12 adolescents with T1D participated in the study.<bold>Interventions: </bold>Subjects in each age group were randomized to automated glycemic control for 48 hours with or without automatically adaptive meal-priming boluses.<bold>Main Outcome Measures: </bold>Mean plasma glucose (PG), time with PG less than 60 mg/dL, and insulin total daily dose were measured.<bold>Results: </bold>The 48-hour mean PG values with and without adaptive meal-priming boluses were 132 ± 9 vs 146 ± 9 mg/dL (P = .03) in adults and 162 ± 6 vs 175 ± 9 mg/dL (P = .01) in adolescents. Adaptive meal-priming boluses improved mean PG without increasing time spent with PG less than 60 mg/dL: 1.4% vs 2.3% (P = .6) in adults and 0.1% vs 0.1% (P = 1.0) in adolescents. Large increases in adaptive meal-priming boluses and shifts in the timing and size of automatic insulin doses occurred in adolescents. Much less adaptation occurred in adults. There was nearly a 4-fold variation in the total daily insulin dose across all cohorts (0.36-1.41 U/kg · d).<bold>Conclusions: </bold>A single control algorithm, initialized only with subject weight, can quickly adapt to regulate glycemia in patients with TID and highly variable insulin requirements.
- Publication
Journal of Clinical Endocrinology & Metabolism, 2014, Vol 99, Issue 5, p1701
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2013-4151