Preventing Hypoglycemia Using Predictive Alarm Algorithms and Insulin Pump Suspension

被引:76
作者
Buckingham, Bruce [1 ]
Cobry, Erin [3 ]
Clinton, Paula
Gage, Victoria [3 ]
Caswell, Kimberly
Kunselman, Elizabeth
Cameron, Fraser [2 ]
Chase, H. Peter [3 ]
机构
[1] Stanford Univ, Dept Pediat Endocrinol, Med Ctr, Stanford, CA 94305 USA
[2] Stanford Univ, Dept Aeronaut & Astronaut, Stanford, CA 94305 USA
[3] Univ Colorado Denver, Barbara Davis Ctr, Aurora, CO USA
基金
美国国家卫生研究院;
关键词
DELIVERY; CHILDREN; DEAD; BED;
D O I
10.1089/dia.2008.0032
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Nocturnal hypoglycemia is a significant problem. From 50% to 75% of hypoglycemia seizures occur at night. Despite the development of real-time glucose sensors (real-time continuous glucose monitor [CGM]) with hypoglycemic alarms, many patients sleep through these alarms. The goal of this pilot study was to assess the feasibility using a real-time CGM to discontinue insulin pump therapy when hypoglycemia was predicted. Methods: Twenty-two subjects with type 1 diabetes had two daytime admissions to a clinical research center. On the first admission their basal insulin was increased until their blood glucose level was <60 mg/dL. On the second admission hypoglycemic prediction algorithms were tested to determine if hypoglycemia was prevented by a 90-min pump shutoff and to determine if the pump shutoff resulted in rebound hyperglycemia. Results: Using a statistical prediction algorithm with an 80 mg/dL threshold and a 30-min projection horizon, hypoglycemia was prevented 60% of the time. Using a linear prediction algorithm with an 80 mg/dL threshold and a 45-min prediction horizon, hypoglycemia was prevented 80% of the time. There was no rebound hyperglycemia following pump suspension. Conclusions: Further development of algorithms is needed to prevent all episodes of hypoglycemia from occurring.
引用
收藏
页码:93 / 97
页数:5
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