Reference : Lower plasma insulin levels during overnight closed loop in schoolchildren with type ...
Scientific journals : Article
Human health sciences : Endocrinology, metabolism & nutrition
http://hdl.handle.net/10993/38664
Lower plasma insulin levels during overnight closed loop in schoolchildren with type 1 diabetes: potential advantage?
English
Schierloh, Ulrike [Pediatric Clinic/Centre Hospitalier de Luxembourg DECCP, Luxembourg]
Wilinska, M. [Department of Paediatrics, University of Cambridge, Cambridge, UK]
Pit-Ten Cate, Ineke mailto [University of Luxembourg > Faculty of Language and Literature, Humanities, Arts and Education (FLSHASE) > Luxembourg Centre for Educational Testing (LUCET) >]
Baumann, P. [Joanneum Research Forschungsgesellschaft, Graz, Austria]
Hovorka, R. [Department of Paediatrics, University of Cambridge, Cambridge, UK]
de Beaufort, Carine [Pediatric Clinic/Centre Hospitalier de Luxembourg DECCP, Luxembourg]
8-Mar-2019
PLoS ONE
Public Library of Science
14
3: e0212013
1-11
Yes (verified by ORBilu)
International
1932-6203
San Franscisco
CA
[en] diabetes Type 1 ; Closed loop ; Metabolic control ; children ; Randomised crossover design
[en] Background
Studies have shown that overnight closed-loop insulin delivery can improve glucose control and reduce the risk of hypoglycemia and hence may improve metabolic outcomes and reduce burden for children with type 1 diabetes and their families. However, research so far has not reported insulin levels while comparing closed-loop to open-loop insulin delivery in children. Therefore, in this study we obtained glucose levels as well plasma insulin levels in children with type 1 diabetes to evaluate the efficacy of a model - based closed-loop algorithm compared to an open-loop administration.
Methods
Fifteen children with type 1 diabetes, 6-12 years, participated in this open-label single center study. We used a randomized cross over design in which we compared overnight closed-loop insulin delivery with sensor augmented pump therapy for two nights in both the hospital and at home (i.e., 1 night in-patient stay and at home per treatment condition). Only during the in-patient stay, hourly plasma insulin and blood glucose levels were assessed and are reported in this paper.
Results
Results of paired sample t-tests revealed that although plasma insulin levels were significantly lower during the closed-loop than in the open-loop (Mean difference 36.51 pmol/l; t(13)=2.13, p=.03, effect size d= 0.57), blood glucose levels did not vary between conditions (mean difference 0.76 mmol/l; t(13)=1.24, p=.12, d=0.37). The administered dose of insulin was significantly lower during the closed-loop compared with the open-loop (mean difference 0.10 UI; t(12)=2.45, p=.02, d=0.68).
Conclusions
Lower insulin doses were delivered in the closed-loop, resulting in lower plasma insulin levels , whereby glucose levels were not affected negatively. This suggests that the closed-loop administration is better targeted and hence could be more effective.
Researchers ; Professionals
http://hdl.handle.net/10993/38664
10.1371/journal.pone.0212013
FP7 ; 305343 - SPIDIMAN - Single-Port Insulin Infusion for Improved Diabetes Management

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