Feasibility of automating insulin delivery for the treatment of type 1 diabetes

被引:281
作者
Steil, Garry M.
Rebrin, Kerstin
Darwin, Christine
Hariri, Farzam
Saad, Mohammed F.
机构
[1] Medtron MiniMed, Northridge, CA 91325 USA
[2] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA
[3] Stony Brook Univ, Dept Med, Stony Brook, NY USA
[4] Stony Brook Univ, Dept Prevent Med, Stony Brook, NY USA
关键词
D O I
10.2337/db06-0419
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
An automated closed-loop insulin delivery system based on subcutaneous glucose sensing and subcutaneous insulin delivery was evaluated in 10 subjects with type 1 diabetes (2 men, 8 women, mean [+/- SD] age 43.4 +/- 11.4 years, duration of diabetes 18.2 +/- 13.5 years). Closed-loop control was assessed over similar to 30 h and compared with open-loop control assessed over 3 days. Closed-loop insulin delivery was calculated using a model of the beta-cell's multiphasic insulin response to glucose. Plasma glucose was 160 +/- 66 mg/dl at the start of closed loop and was thereafter reduced to 71 +/- 19 by 1:00 P.M. (preprandial lunch). Fasting glucose the subsequent morning on closed loop was not different from target (124 +/- 25 vs. 120 mg/dl, respectively; P > 0.05). Mean glucose levels were not different between the open and closed loop (133 +/- 63 vs. 133 +/- 52 mg/dl, respectively; P > 0.65). However, glucose was within the range 70-180 mg/dl 75% of the time under closed loop versus 63% for open loop. Incidence of biochemical hypoglycemia, (blood glucose < 60 mg/dl) was similar under the two treatments. There were no episodes of severe hypoglycemia. The data provide proof of concept that glycemic control can be achieved by a completely automated external closed-loop insulin delivery system.
引用
收藏
页码:3344 / 3350
页数:7
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