Insulin Pump Therapy With Automated Insulin Suspension in Response to Hypoglycemia: Reduction in nocturnal hypoglycemia in those at greatest risk

• Published in: Diabetes care Vol. 34; no. 9; pp. 2023 - 2025
• Main Authors: CHOUDHARY, Pratik, SHIN, John, WANG, Yongyin, EVANS, Mark L, HAMMOND, Peter J, KERR, David, SHAW, James A. M, PICKUP, John C, AMIEL, Stephanie A
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.09.2011
• Subjects: Adult; Biological and medical sciences; Carbohydrates; Care and treatment; Circadian Rhythm - physiology; Clinical trials; Complications and side effects; Diabetes; Diabetes. Impaired glucose tolerance; Dosage and administration; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Humans; Hypoglycemia; Hypoglycemia - drug therapy; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - therapeutic use; Insulin; Insulin - administration & dosage; Insulin - therapeutic use; Insulin Infusion Systems; Insulin pumps; Male; Medical sciences; Metabolic diseases; Middle Aged; Miscellaneous; Original Research; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk factors; Sleep; Type 1 diabetes; Human; Pancreatic hormone; Night; Nutrition; Metabolic diseases; Risk; Suspension; Hypoglycemia; Insulin; Reduction; Treatment; Insulin pump; Risk factor; Endocrinology
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/dc10-2411

To evaluate a sensor-augmented insulin pump with a low glucose suspend (LGS) feature that automatically suspends basal insulin delivery for up to 2 h in response to sensor-detected hypoglycemia. The LGS feature of the Paradigm Veo insulin pump (Medtronic, Inc., Northridge, CA) was tested for 3 weeks in 31 adults with type 1 diabetes. There were 166 episodes of LGS: 66% of daytime LGS episodes were terminated within 10 min, and 20 episodes lasted the maximum 2 h. LGS use was associated with reduced nocturnal duration ≤2.2 mmol/L in those in the highest quartile of nocturnal hypoglycemia at baseline (median 46.2 vs. 1.8 min/day, P = 0.02 [LGS-OFF vs. LGS-ON]). Median sensor glucose was 3.9 mmol/L after 2-h LGS and 8.2 mmol/L at 2 h after basal restart. Use of an insulin pump with LGS was associated with reduced nocturnal hypoglycemia in those at greatest risk and was well accepted by patients.