Manual Closed-Loop Insulin Delivery Using a Saddle Point Model Predictive Control Algorithm: Results of a Crossover Randomized Overnight Study.
J Diabetes Sci Technol
; 11(5): 1007-1014, 2017 09.
Article
em En
| MEDLINE
| ID: mdl-28677416
ABSTRACT
BACKGROUND:
The purpose was to assess the efficacy of a new closed-loop algorithm (Saddle Point Model Predictive Control, SP-MPC) in achieving nocturnal normoglycemia while reducing the risk of hypoglycemia in patients with type 1 diabetes.METHOD:
In this randomized crossover study, 10 adult patients (mean hemoglobin A1c 7.35 ± 1.04%) were assigned to be treated overnight by open loop using sensor-augmented pump therapy (open-loop SAP) or manual closed-loop delivery. During closed loop, insulin doses were calculated using the SP-MPC algorithm and administered as manual boluses every 15 minutes from 900 pm to 800 am. Patients consumed a self-selected meal (65-125 g of carbohydrates) at 700 pm accompanied by their usual prandial bolus. Blood glucose was measured every 30 minutes. The primary endpoints were the time spent in target (70-145 mg/dl) and time spent below 70 mg/dl from 1100 pm to 800 am.RESULTS:
Time spent in target did not differ between closed-loop and open-loop SAP. The number of hypoglycemic events (<70 mg/dl) was reduced 2.8-fold in closed loop (n = 5, median = 0/patient/hour; interquartile range 0-0.11) as compared to open-loop SAP (n = 14, median = 0.22/patient/hour, 0.02-0.22) ( P = .02). The area under the curve for sensor glucose values >145 mg/dl was significantly lower during closed-loop than during open-loop SAP ( P = .03) as well as HBGI ( P = .02).CONCLUSIONS:
This pilot study suggests that the use of the SP-MPC algorithm may improve mean overnight glucose control and reduce the number of hypoglycemic events as compared to SAP therapy.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Algoritmos
/
Sistemas de Infusão de Insulina
/
Diabetes Mellitus Tipo 1
/
Hipoglicemiantes
/
Insulina
Tipo de estudo:
Clinical_trials
/
Guideline
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Diabetes Sci Technol
Assunto da revista:
ENDOCRINOLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
França