Artificial pancreas using a personalized rule-based controller achieves overnight normoglycemia in patients with type 1 diabetes

Capel, Ismael and Rigla, Mercedes and García Sáez, Gema and Rodriguez Herrero, Agustin and Pons, Belén and Subías, David and Garcia Garcia, Fernando and Gallach, María and Aguilar, Montserrat and Pérez Gandía, Carmen and Gómez Aguilera, Enrique J. and Caixàs, Assumpta and Hernando Pérez, María Elena (2014). Artificial pancreas using a personalized rule-based controller achieves overnight normoglycemia in patients with type 1 diabetes. "Diabetes Technology & Therapeutics", v. 16 (n. 3); pp. 1-8. ISSN 1520-9156. https://doi.org/10.1089/dia.2013.0229.

Description

Title: Artificial pancreas using a personalized rule-based controller achieves overnight normoglycemia in patients with type 1 diabetes
Author/s:
  • Capel, Ismael
  • Rigla, Mercedes
  • García Sáez, Gema
  • Rodriguez Herrero, Agustin
  • Pons, Belén
  • Subías, David
  • Garcia Garcia, Fernando
  • Gallach, María
  • Aguilar, Montserrat
  • Pérez Gandía, Carmen
  • Gómez Aguilera, Enrique J.
  • Caixàs, Assumpta
  • Hernando Pérez, María Elena
Item Type: Article
Título de Revista/Publicación: Diabetes Technology & Therapeutics
Date: February 2014
ISSN: 1520-9156
Volume: 16
Subjects:
Faculty: E.T.S.I. Telecomunicación (UPM)
Department: Tecnología Fotónica [hasta 2014]
Creative Commons Licenses: Recognition - No derivative works - Non commercial

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Abstract

Objective: This study assessed the efficacy of a closed-loop (CL) system consisting of a predictive rule-based algorithm (pRBA) on achieving nocturnal and postprandial normoglycemia in patients with type 1 diabetes mellitus (T1DM). The algorithm is personalized for each patient’s data using two different strategies to control nocturnal and postprandial periods. Research Design and Methods: We performed a randomized crossover clinical study in which 10 T1DM patients treated with continuous subcutaneous insulin infusion (CSII) spent two nonconsecutive nights in the research facility: one with their usual CSII pattern (open-loop [OL]) and one controlled by the pRBA (CL). The CL period lasted from 10 p.m. to 10 a.m., including overnight control, and control of breakfast. Venous samples for blood glucose (BG) measurement were collected every 20 min. Results: Time spent in normoglycemia (BG, 3.9–8.0 mmol/L) during the nocturnal period (12 a.m.–8 a.m.), expressed as median (interquartile range), increased from 66.6% (8.3–75%) with OL to 95.8% (73–100%) using the CL algorithm (P<0.05). Median time in hypoglycemia (BG, <3.9 mmol/L) was reduced from 4.2% (0–21%) in the OL night to 0.0% (0.0–0.0%) in the CL night (P<0.05). Nine hypoglycemic events (<3.9 mmol/L) were recorded with OL compared with one using CL. The postprandial glycemic excursion was not lower when the CL system was used in comparison with conventional preprandial bolus: time in target (3.9–10.0 mmol/L) 58.3% (29.1–87.5%) versus 50.0% (50–100%). Conclusions: A highly precise personalized pRBA obtains nocturnal normoglycemia, without significant hypoglycemia, in T1DM patients. There appears to be no clear benefit of CL over prandial bolus on the postprandial glycemia

More information

Item ID: 26094
DC Identifier: http://oa.upm.es/26094/
OAI Identifier: oai:oa.upm.es:26094
DOI: 10.1089/dia.2013.0229
Official URL: http://online.liebertpub.com/doi/abs/10.1089/dia.2013.0229
Deposited by: Memoria Investigacion
Deposited on: 24 May 2014 07:27
Last Modified: 22 Sep 2014 11:39
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