PMID- 21355719
OWN - NLM
STAT- MEDLINE
DCOM- 20110803
LR  - 20111117
IS  - 1557-8593 (Electronic)
IS  - 1520-9156 (Linking)
VI  - 13
IP  - 4
DP  - 2011 Apr
TI  - Automated overnight closed-loop glucose control in young children with type 1 
      diabetes.
PG  - 419-24
LID - 10.1089/dia.2010.0176 [doi]
AB  - BACKGROUND: We evaluated the effectiveness of automated overnight closed-loop 
      (AOCL) insulin delivery and the influence of timing of initiation on glucose 
      control overnight in young children with type 1 diabetes (T1D). METHODS: Eight 
      children with T1D (four boys, four girls) (mean +/- SD: 9.4 +/- 2.7 years old; body 
      mass index, 18.3 +/- 2.3 kg/m(2); duration of diabetes, 3.9 +/- 2.5 years; total 
      daily insulin dose, 0.7 +/- 0.1 U/kg/day; glycosylated hemoglobin, 7.9 +/- 0.9%) were 
      studied in a clinical research facility on two separate occasions. Subjects had a 
      meal at 18:00 (77 +/- 8 g of carbohydrate [CHO]) and snack at 21:00 (21 +/- 6 g of 
      CHO), both accompanied by a prandial insulin bolus. In random order, AOCL was 
      started at 18:00 or 21:00 h and ran until 08:00 h the next day. Subcutaneous 
      continuous glucose monitoring data were fed automatically into the model 
      predictive control algorithm. Calculated subcutaneous insulin infusion rates were 
      sent wirelessly to an insulin pump. Plasma glucose was measured to assess 
      closed-loop performance. RESULTS: No rescue CHOs were administered. Time spent 
      with plasma glucose in the target range from 3.9 to 8.0 mmol/L was 50.7% (29.0%, 
      72.2%), and it did not differ on the two occasions: median (interquartile range), 
      42% (18%, 64%) versus 58% (32%, 79%) (P = 0.161). Time when plasma glucose was 
      above 8.0 mmol/L (42% [25%, 82%] vs. 29% [14%, 64%], P = 0.093), time below 3.9 
      mmol/L (0% [0%, 11%] vs. 8% [0%, 17%], P = 0.500), low blood glucose index (0.1 
      [0.0, 2.5] vs. 1.7 [0.4, 3.3], P = 0.380), plasma glucose at the start of AOCL 
      (12.5 +/- 2.7 vs. 11.6 +/- 4.2 mmol/L, P = 0.562), and mean overnight plasma glucose 
      (8.3 +/- 2.1 vs. 7.5 +/- 2.2 mmol/L, P = 0.246) were also similar. CONCLUSIONS: AOCL 
      is feasible in young children with T1D. Comparable results were obtained when 
      closed-loop was initiated at 18:00 or 21:00 h.
FAU - Elleri, Daniela
AU  - Elleri D
AD  - Metabolic Research Laboratories, Institute of Metabolic Science, University of 
      Cambridge, Cambridge, United Kingdom.
FAU - Allen, Janet M
AU  - Allen JM
FAU - Nodale, Marianna
AU  - Nodale M
FAU - Wilinska, Malgorzata E
AU  - Wilinska ME
FAU - Mangat, Jasdip S
AU  - Mangat JS
FAU - Larsen, Anne Mette F
AU  - Larsen AM
FAU - Acerini, Carlo L
AU  - Acerini CL
FAU - Dunger, David B
AU  - Dunger DB
FAU - Hovorka, Roman
AU  - Hovorka R
LA  - eng
GR  - Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110228
PL  - United States
TA  - Diabetes Technol Ther
JT  - Diabetes technology & therapeutics
JID - 100889084
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Blood Glucose/analysis/*metabolism
MH  - Child
MH  - Diabetes Mellitus, Type 1/*blood/*drug therapy
MH  - Female
MH  - Humans
MH  - Hypoglycemic Agents/*administration & dosage
MH  - Infusion Pumps, Implantable
MH  - Insulin/*administration & dosage
MH  - *Insulin Infusion Systems
MH  - Male
MH  - Statistics, Nonparametric
EDAT- 2011/03/02 06:00
MHDA- 2011/08/04 06:00
CRDT- 2011/03/02 06:00
PHST- 2011/03/02 06:00 [entrez]
PHST- 2011/03/02 06:00 [pubmed]
PHST- 2011/08/04 06:00 [medline]
AID - 10.1089/dia.2010.0176 [doi]
PST - ppublish
SO  - Diabetes Technol Ther. 2011 Apr;13(4):419-24. doi: 10.1089/dia.2010.0176. Epub 
      2011 Feb 28.