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...

Full description

Saved in:
Bibliographic Details
Published inDiabetes (New York, N.Y.) Vol. 70; no. Supplement_1
Main Authors KAUR, RAVINDER JEET, DESHPANDE, SUNIL, PINSKER, JORDAN E., MCCRADY-SPITZER, SHELLY K., DESJARDINS, DONNA, CHURCH, MEI MEI, KREMERS, WALTER K., DOYLE, FRANCIS J., DASSAU, EYAL, KUDVA, YOGISH C.
Format Journal Article
LanguageEnglish
Published New York American Diabetes Association 01.06.2021
Subjects
Online AccessGet full text
ISSN0012-1797
1939-327X
DOI10.2337/db21-703-P

Cover

Loading…
More Information
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.
Bibliography:ObjectType-Conference Proceeding-1
SourceType-Scholarly Journals-1
content type line 14
ISSN:0012-1797
1939-327X
DOI:10.2337/db21-703-P