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May 19, 2015 15:11:25 GMT -5
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www.ncbi.nlm.nih.gov/pubmed/25901023
J Diabetes Sci Technol. 2015 May;9(3):564-72. doi: 10.1177/1932296815582061. Epub 2015 Apr 21.
Clinical results of an automated artificial pancreas using technosphere inhaled insulin to mimic first-phase insulin secretion.
Zisser H1, Dassau E2, Lee JJ3, Harvey RA3, Bevier W4, Doyle FJ 3rd2.
Author information
Abstract
OBJECTIVE:
The purpose of this study was to investigate whether or not adding a fixed preprandial dose of inhaled insulin to a fully automated closed loop artificial pancreas would improve the postprandial glucose control without adding an increased risk of hypoglycemia.
RESEARCH DESIGN AND METHODS:
Nine subjects with T1DM were recruited for the study. The patients were on closed-loop control for 24 hours starting around 4:30 pm. Mixed meals (~50 g CHO) were given at 6:30 pm and 7:00 am the following day. For the treatment group each meal was preceded by the inhalation of one 10 U dose of Technosphere Insulin (TI). Subcutaneous insulin delivery was controlled by a zone model predictive control algorithm (zone-MPC). At 11:00 am, the patient exercised for 30 ± 5 minutes at 50% of predicted heart rate reserve.
RESULTS:
The use of TI resulted in increasing the median percentage time in range (70-180 mg/dl, BG) during the 5-hour postprandial period by 21.6% (81.6% and 60% in the with/without TI cases, respectively, P = .06) and reducing the median postprandial glucose peak by 33 mg/dl (172 mg/dl and 205 mg/dl in the with and without TI cases, respectively, P = .004). The median percentage time in range 80-140 mg/dl during the entire study period was 67.5% as compared to percentage time in range without the use of TI of 55.2% (P = .03).
CONCLUSIONS:
Adding preprandial TI (See video supplement) to an automated closed-loop AP system resulted in superior postprandial control as demonstrated by lower postprandial glucose exposure without addition hypoglycemia.
© 2015 Diabetes Technology Society.
KEYWORDS:
Health Monitoring System; artificial pancreas; closed-loop; glucose control; hypoglycemia mitigation; inhaled insulin; telemedicine; type 1 diabetes; unannounced meals; zone-MPC
J Diabetes Sci Technol. 2015 May;9(3):564-72. doi: 10.1177/1932296815582061. Epub 2015 Apr 21.
Clinical results of an automated artificial pancreas using technosphere inhaled insulin to mimic first-phase insulin secretion.
Zisser H1, Dassau E2, Lee JJ3, Harvey RA3, Bevier W4, Doyle FJ 3rd2.
Author information
Abstract
OBJECTIVE:
The purpose of this study was to investigate whether or not adding a fixed preprandial dose of inhaled insulin to a fully automated closed loop artificial pancreas would improve the postprandial glucose control without adding an increased risk of hypoglycemia.
RESEARCH DESIGN AND METHODS:
Nine subjects with T1DM were recruited for the study. The patients were on closed-loop control for 24 hours starting around 4:30 pm. Mixed meals (~50 g CHO) were given at 6:30 pm and 7:00 am the following day. For the treatment group each meal was preceded by the inhalation of one 10 U dose of Technosphere Insulin (TI). Subcutaneous insulin delivery was controlled by a zone model predictive control algorithm (zone-MPC). At 11:00 am, the patient exercised for 30 ± 5 minutes at 50% of predicted heart rate reserve.
RESULTS:
The use of TI resulted in increasing the median percentage time in range (70-180 mg/dl, BG) during the 5-hour postprandial period by 21.6% (81.6% and 60% in the with/without TI cases, respectively, P = .06) and reducing the median postprandial glucose peak by 33 mg/dl (172 mg/dl and 205 mg/dl in the with and without TI cases, respectively, P = .004). The median percentage time in range 80-140 mg/dl during the entire study period was 67.5% as compared to percentage time in range without the use of TI of 55.2% (P = .03).
CONCLUSIONS:
Adding preprandial TI (See video supplement) to an automated closed-loop AP system resulted in superior postprandial control as demonstrated by lower postprandial glucose exposure without addition hypoglycemia.
© 2015 Diabetes Technology Society.
KEYWORDS:
Health Monitoring System; artificial pancreas; closed-loop; glucose control; hypoglycemia mitigation; inhaled insulin; telemedicine; type 1 diabetes; unannounced meals; zone-MPC