Literature DB >> 25611577

Retrospective analysis of the real-world use of the threshold suspend feature of sensor-augmented insulin pumps.

Pratik Agrawal1, Alex Zhong, John B Welsh, Rajiv Shah, Francine R Kaufman.   

Abstract

BACKGROUND: The automatic Threshold Suspend (TS) feature of the MiniMed 530G system (Medtronic MiniMed, Inc., Northridge, CA), when enabled, suspends insulin delivery for up to 2 h when the sensor glucose (SG) value reaches a preset threshold.
MATERIALS AND METHODS: SG data from 20,973 patients who enabled the TS feature at their discretion and uploaded pump and sensor data to CareLink(®) (Medtronic MiniMed, Inc.) from October 15, 2013 to July 21, 2014 were analyzed. Comparisons between 758,382 patient-days wherein the TS feature was enabled at any time and 166,791 patient-days in which it was not enabled were made. Further comparisons were made between data collected during daytime (8:00 a.m. to 10:00 p.m.) and nighttime (10:00 p.m. to 8:00 a.m.) hours. Data from subsets of patients who enabled the TS feature all of the time (n=14,673) versus those who never enabled the TS feature (n=2,249) were also compared. Recovery from hypoglycemia during and after 2-h pump suspension events was also assessed.
RESULTS: The TS feature was enabled on 82% of patient-days. Patient-days in which the TS feature was enabled, compared with patient-days in which it was not, had 69% fewer SG values ≤50 mg/dL (0.64% vs. 2.09%, respectively; P<0.001). The reduction in hypoglycemia seen on TS-enabled days was more pronounced during nighttime than during daytime hours. SG data from full-time users of the TS feature reflected a 62% reduction in values ≤50 mg/dL and a 5.6% reduction in values ≥300 mg/dL compared with data from nonusers (P<0.001 for each). The median SG value at the start of 2-h suspensions was 60 (interquartile range [IQR], 57-66) mg/dL, immediately after was 87 (IQR, 63-123) mg/dL, and 4 h later was 164 (IQR, 117-220) mg/dL.
CONCLUSIONS: The TS feature, when enabled consistently, reduced hypoglycemic exposure, and for those who had it enabled 100% of the time, hyperglycemia was also reduced.

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Year:  2015        PMID: 25611577      PMCID: PMC4397987          DOI: 10.1089/dia.2014.0257

Source DB:  PubMed          Journal:  Diabetes Technol Ther        ISSN: 1520-9156            Impact factor:   6.118


  7 in total

1.  Reduction in duration of hypoglycemia by automatic suspension of insulin delivery: the in-clinic ASPIRE study.

Authors:  Satish Garg; Ronald L Brazg; Timothy S Bailey; Bruce A Buckingham; Robert H Slover; David C Klonoff; John Shin; John B Welsh; Francine R Kaufman
Journal:  Diabetes Technol Ther       Date:  2012-02-08       Impact factor: 6.118

2.  Accuracy and acceptability of the 6-day Enlite continuous subcutaneous glucose sensor.

Authors:  Timothy S Bailey; Andrew Ahmann; Ronald Brazg; Mark Christiansen; Satish Garg; Elaine Watkins; John B Welsh; Scott W Lee
Journal:  Diabetes Technol Ther       Date:  2014-04-07       Impact factor: 6.118

3.  Prevention of hypoglycemia by using low glucose suspend function in sensor-augmented pump therapy.

Authors:  Thomas Danne; Olga Kordonouri; Martin Holder; Holger Haberland; Sven Golembowski; Kerstin Remus; Sara Bläsig; Tanja Wadien; Susanne Zierow; Reinhard Hartmann; Andreas Thomas
Journal:  Diabetes Technol Ther       Date:  2011-08-09       Impact factor: 6.118

4.  Usage and effectiveness of the low glucose suspend feature of the Medtronic Paradigm Veo insulin pump.

Authors:  Pratik Agrawal; John B Welsh; Brian Kannard; Sina Askari; Qingqing Yang; Francine R Kaufman
Journal:  J Diabetes Sci Technol       Date:  2011-09-01

5.  Effect of sensor-augmented insulin pump therapy and automated insulin suspension vs standard insulin pump therapy on hypoglycemia in patients with type 1 diabetes: a randomized clinical trial.

Authors:  Trang T Ly; Jennifer A Nicholas; Adam Retterath; Ee Mun Lim; Elizabeth A Davis; Timothy W Jones
Journal:  JAMA       Date:  2013-09-25       Impact factor: 56.272

6.  Threshold-based insulin-pump interruption for reduction of hypoglycemia.

Authors:  Richard M Bergenstal; David C Klonoff; Satish K Garg; Bruce W Bode; Melissa Meredith; Robert H Slover; Andrew J Ahmann; John B Welsh; Scott W Lee; Francine R Kaufman
Journal:  N Engl J Med       Date:  2013-06-22       Impact factor: 91.245

7.  Insulin pump therapy with automated insulin suspension in response to hypoglycemia: reduction in nocturnal hypoglycemia in those at greatest risk.

Authors:  Pratik Choudhary; John Shin; Yongyin Wang; Mark L Evans; Peter J Hammond; David Kerr; James A M Shaw; John C Pickup; Stephanie A Amiel
Journal:  Diabetes Care       Date:  2011-09       Impact factor: 19.112

  7 in total
  13 in total

1.  A Review of Continuous Glucose Monitoring Data Interpretation in the Age of Automated Insulin Delivery.

Authors:  Laya Ekhlaspour; Ideen Tabatabai; Bruce Buckingham
Journal:  J Diabetes Sci Technol       Date:  2019-05-26

Review 2.  Hypo- and Hyperglycemic Alarms: Devices and Algorithms.

Authors:  Daniel Howsmon; B Wayne Bequette
Journal:  J Diabetes Sci Technol       Date:  2015-04-30

Review 3.  Update on Clinical Utility of Continuous Glucose Monitoring in Type 1 Diabetes.

Authors:  Nalani Haviland; John Walsh; Ruth Roberts; Timothy S Bailey
Journal:  Curr Diab Rep       Date:  2016-11       Impact factor: 4.810

Review 4.  CGM, Pregnancy, and Remote Monitoring.

Authors:  Sarit Polsky; Rachel Garcetti
Journal:  Diabetes Technol Ther       Date:  2017-06       Impact factor: 6.118

Review 5.  Continuous Glucose Monitoring: A Review of Recent Studies Demonstrating Improved Glycemic Outcomes.

Authors:  David Rodbard
Journal:  Diabetes Technol Ther       Date:  2017-06       Impact factor: 6.118

6.  Predictors of Hypoglycemia in the ASPIRE In-Home Study and Effects of Automatic Suspension of Insulin Delivery.

Authors:  Ram Weiss; Satish K Garg; Richard M Bergenstal; David C Klonoff; Bruce W Bode; Timothy S Bailey; James Thrasher; Frank Schwartz; John B Welsh; Francine R Kaufman
Journal:  J Diabetes Sci Technol       Date:  2015-05-18

Review 7.  Influences on Technology Use and Efficacy in Type 1 Diabetes.

Authors:  Victoria Franklin
Journal:  J Diabetes Sci Technol       Date:  2016-05-03

8.  Progress in Diabetes Technology: Developments in Insulin Pumps, Continuous Glucose Monitors, and Progress towards the Artificial Pancreas.

Authors:  Gregory P Forlenza; Bruce Buckingham; David M Maahs
Journal:  J Pediatr       Date:  2015-11-05       Impact factor: 4.406

Review 9.  Artificial Pancreas Technology Offers Hope for Childhood Diabetes.

Authors:  Melissa J Schoelwer; Mark D DeBoer
Journal:  Curr Nutr Rep       Date:  2021-01-07

10.  The hypoglycemia-prevention effect of sensor-augmented pump therapy with predictive low glucose management in Japanese patients with type 1 diabetes mellitus: a short-term study.

Authors:  Akihiro Katayama; Atsuhito Tone; Mayu Watanabe; Sanae Teshigawara; Satoshi Miyamoto; Jun Eguchi; Atsuko Nakatsuka; Kenichi Shikata; Jun Wada
Journal:  Diabetol Int       Date:  2019-09-16
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