Article (Scientific journals)
Lower plasma insulin levels during overnight closed loop in schoolchildren with type 1 diabetes: potential advantage?
Schierloh, Ulrike; Wilinska, M.; Pit-Ten Cate, Ineke et al.
2019In PLoS ONE, 14 (3: e0212013), p. 1-11
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Keywords :
diabetes Type 1; Closed loop; Metabolic control; children; Randomised crossover design
Abstract :
[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.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Schierloh, Ulrike;  Pediatric Clinic/Centre Hospitalier de Luxembourg DECCP, Luxembourg
Wilinska, M.;  Department of Paediatrics, University of Cambridge, Cambridge, UK
Pit-Ten Cate, Ineke ;  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
External co-authors :
yes
Language :
English
Title :
Lower plasma insulin levels during overnight closed loop in schoolchildren with type 1 diabetes: potential advantage?
Publication date :
08 March 2019
Journal title :
PLoS ONE
ISSN :
1932-6203
Publisher :
Public Library of Science, San Franscisco, United States - California
Volume :
14
Issue :
3: e0212013
Pages :
1-11
Peer reviewed :
Peer Reviewed verified by ORBi
European Projects :
FP7 - 305343 - SPIDIMAN - Single-Port Insulin Infusion for Improved Diabetes Management
Funders :
CE - Commission Européenne [BE]
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since 06 February 2019

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