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Performance of an Automated Insulin Delivery System: Results of Early Phase Feasibility Studies.
Christiansen, Mark; Bartee, Amy; Lalonde, Amy; Jones, Richard E; Katz, Michelle; Wolpert, Howard; Brazg, Ronald.
Afiliación
  • Christiansen M; Diablo Clinical Research, Walnut Creek, California, USA.
  • Bartee A; Eli Lilly and Company, Indianapolis, Indiana, USA.
  • Lalonde A; Eli Lilly and Company, Indianapolis, Indiana, USA.
  • Jones RE; Eli Lilly and Company, Indianapolis, Indiana, USA.
  • Katz M; Eli Lilly and Company, Indianapolis, Indiana, USA.
  • Wolpert H; Eli Lilly and Company, Indianapolis, Indiana, USA.
  • Brazg R; Ranier Clinical Research Center, Renton, West Virginia, USA.
Diabetes Technol Ther ; 23(3): 187-194, 2021 03.
Article en En | MEDLINE | ID: mdl-32940537
Background: Automated insulin delivery (AID) systems have demonstrated improvements in time-in-range (TIR, blood glucose 70-180 mg/dL) without increasing hypoglycemia. Testing a closed-loop system in an inpatient environment with supervised challenges allows for initial evaluation of performance and safety of the system. Methods: Adults with type 1 diabetes (T1D) were enrolled into two similar studies (n = 10 per study), with 3-day inpatient analysis periods. Participants tested a Lilly hybrid closed-loop (HCL) system comprising an investigational insulin pump, insulin lispro, a pump-embedded model predictive control algorithm, a continuous glucose monitor (CGM), and an external dedicated controller. Each protocol included meal-related and exercise challenges to simulate real-world diabetes self-management errors. Only study staff interacted with the HCL system. Performance was assessed using standard CGM metrics overall and within prespecified periods. Results: Participants (25% male) had mean ± standard deviation (SD) age 44.7 ± 14.2 years, T1D duration 30.2 ± 11.1 years, A1C 7.2% ± 0.8%, and insulin usage 0.53 ± 0.21 U/(kg·day). Percentage TIR 70-180 mg/dL (mean ± SD) was 81.2 ± 8.4 overall, 85.2 ± 8.1 outside of challenge periods, 97.3 ± 5.3 during the nocturnal periods, and 74.5 ± 16.2 for the postprandial periods. During challenge periods, percentage TIR for the overbolus challenge was 65.4 ± 29.2 and that for the delayed bolus challenge was 57.1 ± 25.1. No adverse events (AEs), serious AEs, or unanticipated adverse device events occurred while participants were using the HCL system. Conclusions: In participants with T1D, Lilly AID system demonstrated expected algorithm performance and safety with satisfactory glycemic outcomes overall and in response to simulated diabetes management challenges. Additional studies in less supervised conditions and with broader patient populations are warranted. ClinicalTrials.gov Registration number NCT03743285, NCT03849612.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistemas de Infusión de Insulina / Páncreas Artificial / Diabetes Mellitus Tipo 1 Tipo de estudio: Guideline / Prognostic_studies Aspecto: Implementation_research Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Diabetes Technol Ther Asunto de la revista: ENDOCRINOLOGIA / TERAPEUTICA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistemas de Infusión de Insulina / Páncreas Artificial / Diabetes Mellitus Tipo 1 Tipo de estudio: Guideline / Prognostic_studies Aspecto: Implementation_research Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Diabetes Technol Ther Asunto de la revista: ENDOCRINOLOGIA / TERAPEUTICA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos