AIMS: To test in an outpatient setting the safety and efficacy of continuous subcutaneous insulin infusion (CSII) driven by a modular model predictive control (MMPC) algorithm informed by continuous glucose monitoring (CGM) measurement. METHODS: 13 patients affected by type 1 diabetes participated to a non-randomized outpatient 42-h experiment that included two evening meals and overnight periods (in short, dinner & night periods). CSII was patient-driven during dinner & night period 1 and MMPC-driven during dinner&night period 2. The study was conducted in hotels, where patients could move around freely. A CGM system (G4 Platinum; Dexcom Inc., San Diego, CA, USA) and insulin pump (AccuChek Combo; Roche Diagnostics, Mannheim, Germany) were connected wirelessly to a smartphone-based platform (DiAs, Diabetes Assistant; University of Virginia, Charlottesville, VA, USA) during both periods. RESULTS: A significantly lower percentage of time spent with glucose levels <3.9 mmol/l was achieved in period 2 compared with period 1: 1.96 ± 4.56% vs 12.76 ± 15.84% (mean ± standard deviation, p < 0.01), together with a greater percentage of time spent in the 3.9-10 mmol/l target range: 83.56 ± 14.02% vs 62.43 ± 29.03% (p = 0.04). In addition, restricting the analysis to the overnight phases, a lower percentage of time spent with glucose levels <3.9 mmol/l (1.92 ± 4.89% vs 12.7 ± 19.75%; p = 0.03) was combined with a greater percentage of time spent in 3.9-10 mmol/l target range in period 2 compared with period 1 (92.16 ± 8.03% vs 63.97 ± 2.73%; p = 0.01). Average glucose levels were similar during both periods. CONCLUSIONS: The results suggest that MMPC managed by a wearable system is safe and effective during evening meal and overnight. Its sustained use during this period is currently being tested in an ongoing randomized 2-month study.
AIMS: To test in an outpatient setting the safety and efficacy of continuous subcutaneous insulin infusion (CSII) driven by a modular model predictive control (MMPC) algorithm informed by continuous glucose monitoring (CGM) measurement. METHODS: 13 patients affected by type 1 diabetes participated to a non-randomized outpatient 42-h experiment that included two evening meals and overnight periods (in short, dinner & night periods). CSII was patient-driven during dinner & night period 1 and MMPC-driven during dinner&night period 2. The study was conducted in hotels, where patients could move around freely. A CGM system (G4 Platinum; Dexcom Inc., San Diego, CA, USA) and insulin pump (AccuChek Combo; Roche Diagnostics, Mannheim, Germany) were connected wirelessly to a smartphone-based platform (DiAs, Diabetes Assistant; University of Virginia, Charlottesville, VA, USA) during both periods. RESULTS: A significantly lower percentage of time spent with glucose levels <3.9 mmol/l was achieved in period 2 compared with period 1: 1.96 ± 4.56% vs 12.76 ± 15.84% (mean ± standard deviation, p < 0.01), together with a greater percentage of time spent in the 3.9-10 mmol/l target range: 83.56 ± 14.02% vs 62.43 ± 29.03% (p = 0.04). In addition, restricting the analysis to the overnight phases, a lower percentage of time spent with glucose levels <3.9 mmol/l (1.92 ± 4.89% vs 12.7 ± 19.75%; p = 0.03) was combined with a greater percentage of time spent in 3.9-10 mmol/l target range in period 2 compared with period 1 (92.16 ± 8.03% vs 63.97 ± 2.73%; p = 0.01). Average glucose levels were similar during both periods. CONCLUSIONS: The results suggest that MMPC managed by a wearable system is safe and effective during evening meal and overnight. Its sustained use during this period is currently being tested in an ongoing randomized 2-month study.
Authors: Gregory P Forlenza; Laya Ekhlaspour; Marc Breton; David M Maahs; R Paul Wadwa; Mark DeBoer; Laurel H Messer; Marissa Town; Jennifer Pinnata; Geoff Kruse; Bruce A Buckingham; Daniel Cherñavvsky Journal: Diabetes Technol Ther Date: 2019-03-19 Impact factor: 6.118
Authors: Konstantia Zarkogianni; Eleni Litsa; Konstantinos Mitsis; Po-Yen Wu; Chanchala D Kaddi; Chih-Wen Cheng; May D Wang; Konstantina S Nikita Journal: IEEE Trans Biomed Eng Date: 2015-08-19 Impact factor: 4.538
Authors: Stacey M Anderson; Eyal Dassau; Dan Raghinaru; John Lum; Sue A Brown; Jordan E Pinsker; Mei Mei Church; Carol Levy; David Lam; Yogish C Kudva; Bruce Buckingham; Gregory P Forlenza; R Paul Wadwa; Lori Laffel; Francis J Doyle; J Hans DeVries; Eric Renard; Claudio Cobelli; Federico Boscari; Simone Del Favero; Boris P Kovatchev Journal: Diabetes Technol Ther Date: 2019-01-16 Impact factor: 6.118
Authors: Stacey M Anderson; Dan Raghinaru; Jordan E Pinsker; Federico Boscari; Eric Renard; Bruce A Buckingham; Revital Nimri; Francis J Doyle; Sue A Brown; Patrick Keith-Hynes; Marc D Breton; Daniel Chernavvsky; Wendy C Bevier; Paige K Bradley; Daniela Bruttomesso; Simone Del Favero; Roberta Calore; Claudio Cobelli; Angelo Avogaro; Anne Farret; Jerome Place; Trang T Ly; Satya Shanmugham; Moshe Phillip; Eyal Dassau; Isuru S Dasanayake; Craig Kollman; John W Lum; Roy W Beck; Boris Kovatchev Journal: Diabetes Care Date: 2016-04-13 Impact factor: 19.112