Overnight Closed-Loop Insulin Delivery in Young People With Type 1 Diabetes: A Free-Living, Randomized Clinical Trial

• DOI: 10.2337/dc13-2644
• Publication Date: 2014-04-22T19:53:02Z
• Authors: Roman Hovorka; Daniela Elleri; Hood Thabit; Janet M. Allen; Lalantha Leelarathna; Ranna El-Khairi; Kavita Kumareswaran; Karen Caldwell; Peter Calhoun; Craig Kollman; Helen R. Murphy; Carlo L. Acerini; Malgorzata E. Wil...; Marianna Nodale; David B. Dunger
• Keywords: Interquartile range; Insulin delivery; Blood Glucose Self-Monitoring

OBJECTIVE To evaluate feasibility, safety, and efficacy of overnight closed-loop insulin delivery in free-living youth with type 1 diabetes. RESEARCH DESIGN AND METHODS Overnight closed loop was evaluated at home by 16 pump-treated adolescents diabetes aged 12–18 years. Over a 3-week period, directed system, on another period sensor-augmented therapy applied. The order interventions random. primary end point time when adjusted sensor glucose between 3.9 8.0 mmol/L from 2300 to 0700 h. RESULTS Closed constantly applied over least 4 h 269 nights (80%); data were collected 282 control (84%). increased spent target median 15% (interquartile range −9 43; P < 0.001). Mean reduced mean 14 (SD 58) mg/dL (P Time <70 low both groups, but <63 for 20 min less frequent during (10 vs. 17%; = 0.01). Despite lower total daily doses 2.3 −4.7 9.3) units 0.009), overall 24-h 9 41) 0.006) loop. CONCLUSIONS Unsupervised use is safe feasible. Glucose improved the day night fewer episodes nocturnal hypoglycemia.