703-P: Randomized Crossover Comparison of Automated Insulin Delivery vs. Conventional Therapy with Scheduled Stress Challenges
Automated Insulin Delivery (AID) hybrid closed-loop systems have not been well studied in the context of psychological and physiological stress. We evaluated our interoperable artificial pancreas system with in-clinic stress challenges in a randomized crossover trial. Fourteen adults with type 1 dia...
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Published in | Diabetes (New York, N.Y.) Vol. 70; no. Supplement_1 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
New York
American Diabetes Association
01.06.2021
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Subjects | |
Online Access | Get full text |
ISSN | 0012-1797 1939-327X |
DOI | 10.2337/db21-703-P |
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Summary: | Automated Insulin Delivery (AID) hybrid closed-loop systems have not been well studied in the context of psychological and physiological stress. We evaluated our interoperable artificial pancreas system with in-clinic stress challenges in a randomized crossover trial. Fourteen adults with type 1 diabetes were randomized to 2 weeks of AID-based control and two weeks of sensor augmented pump (SAP)l therapy at home in random order. The AID system used the Zone-Model Predictive Control algorithm with a continuous function of glucose velocity and insulin-on-board to gradually increase insulin infusion under conditions of sustained hyperglycemia. During each two-week period, in-clinic stress assessments for psychological stress (TSST and SECPT) and pharmacological stress (hydrocortisone 40-20-20 mg) were performed. Ten subjects completed the study per protocol, with 48 stress sessions completed in 12 subjects. AID increased time 70-180mg/dL from 63.1 to 74.4% (p=0.001), decreased time <70mg/dL from 1.5 to 0.8% (p=0.04) and decreased time >180mg/dL from 35.4 to 24.8% (p=0.001) during the 2 weeks outpatient use. AID decreased glycemic variability as measured by CV (p=0.037) and time <70mg/dL (p=0.014) during psychological stress (Table 1) AID improved glucose control during outpatient use and improved CV and % time <70mg/dL during in-clinic psychologic stress compared to SAP. |
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Bibliography: | ObjectType-Conference Proceeding-1 SourceType-Scholarly Journals-1 content type line 14 |
ISSN: | 0012-1797 1939-327X |
DOI: | 10.2337/db21-703-P |