RESUMO
BACKGROUND: Optimization of automated insulin delivery (AID) settings is required to achieve desirable glycemic outcomes. We evaluated safety and efficacy of a computerized system to initialize and adjust insulin delivery settings for the t:slim X2 insulin pump with Control-IQ technology in adults with type 1 diabetes (T1D). METHODS: After a 2-week continuous glucose monitoring (CGM) run-in period, adults with T1D using multiple daily injections (MDI) (N = 33, mean age 36.1 years, 57.6% female, diabetes duration 19.7 years) were transitioned to 13 weeks of Control-IQ technology usage. A computerized algorithm generated recommendations for initial pump settings (basal rate, insulin-to-carbohydrate ratio, and correction factor) and weekly follow-up settings to optimize glycemic outcomes. Physicians could override the automated settings changes for safety concerns. RESULTS: Time in range 70 to 180 mg/dL improved from 45.7% during run-in to 69.1% during the last 30 days of Control-IQ use, a median improvement of 18.8% (95% confidence interval [CI]: 13.6-23.9, P < .001). This improvement was evident early in the study and was sustained over 13 weeks. Time <70 mg/dL showed a gradual decreasing trend over time. Percentage of participants achieving HbA1c <7% went from zero at baseline to 55% at study end (P < .001). Only six of the 318 automated settings adaptations (1.9%) were overridden by study investigators. CONCLUSIONS: Computerized initiation and adaptation of Control-IQ technology settings from baseline MDI therapy was safe in adults with T1D. The use of this simplified system for onboarding and optimizing Control-IQ technology may be useful to increase uptake of AID and reduce staff and patient burden in clinical care.
RESUMO
The SNARC (spatial-numerical association of response codes) effect is the finding that people are generally faster to respond to smaller numbers with left-sided responses and larger numbers with right-sided responses. The SNARC effect has been widely reported for responses to symbolic representations of number such as digits. However, there is mixed evidence as to whether it occurs for non-symbolic representations of number, particularly when magnitude is irrelevant to the task. Mitchell et al. reported a SNARC effect when participants were asked to make orientation decisions to arrays of one-to-nine triangles (pointing upwards vs. pointing downwards) and concluded that SNARC effects occur for non-symbolic, non-canonical representations of number. They additionally reported that this effect was stronger in the subitising range. However, here we report four experiments that do not replicate either of these findings. Participants made upwards/inverted decisions to one-to-nine triangles where total surface area was either controlled across numerosities (Experiments 1, 2, and 4) or increased congruently with numerosity (Experiment 3). There was no evidence of a SNARC effect either across the full range or within the subset of the subitising range. The results of Experiment 4 (in which we presented the original stimuli of Mitchell et al.) suggested that visual properties of non-symbolic displays can prompt SNARC-like effects driven by visual cues rather than numerosity. Taken in the context of other recent findings, we argue that non-symbolic representations of number do not offer a direct and automatic route to numerical-spatial associations.