overnight closed-loop insulin delivery in young people with type 1 diabetes: a free- living,...
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![Page 1: Overnight Closed-Loop Insulin Delivery in Young People With Type 1 Diabetes: A Free- Living, Randomized Clinical Trial Featured Article: Roman Hovorka,](https://reader036.vdocuments.site/reader036/viewer/2022062515/56649f445503460f94c652ed/html5/thumbnails/1.jpg)
Overnight Closed-Loop Insulin Delivery in Young People With Type 1 Diabetes: A Free-
Living, Randomized Clinical Trial
Featured Article:
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. Wilinska, Marianna Nodale, and David B. Dunger
Diabetes Care Volume 37: 1204-1211
May, 2014
![Page 2: Overnight Closed-Loop Insulin Delivery in Young People With Type 1 Diabetes: A Free- Living, Randomized Clinical Trial Featured Article: Roman Hovorka,](https://reader036.vdocuments.site/reader036/viewer/2022062515/56649f445503460f94c652ed/html5/thumbnails/2.jpg)
STUDY OBJECTIVE
• To evaluate feasibility, safety, and efficacy of overnight closed-loop insulin delivery in free-living youth with type 1 diabetes
Hovorka R. et al. Diabetes Care 2014;37:1204-1211
![Page 3: Overnight Closed-Loop Insulin Delivery in Young People With Type 1 Diabetes: A Free- Living, Randomized Clinical Trial Featured Article: Roman Hovorka,](https://reader036.vdocuments.site/reader036/viewer/2022062515/56649f445503460f94c652ed/html5/thumbnails/3.jpg)
STUDY DESIGN AND METHODS
• Overnight closed loop was evaluated at home by 16 pump-treated adolescents with type 1 diabetes aged 12–18 years
• Over a 3-week period, overnight insulin delivery was directed by a closed-loop system
• On another 3-week period, sensor-augmented therapy was applied
• Order of interventions was random
• Primary end point was time when adjusted sensor glucose was between 3.9 and 8.0 mmol/L from 2300 to 0700 h
Hovorka R. et al. Diabetes Care 2014;37:1204-1211
![Page 4: Overnight Closed-Loop Insulin Delivery in Young People With Type 1 Diabetes: A Free- Living, Randomized Clinical Trial Featured Article: Roman Hovorka,](https://reader036.vdocuments.site/reader036/viewer/2022062515/56649f445503460f94c652ed/html5/thumbnails/4.jpg)
Hovorka R. et al. Diabetes Care 2014;37:1204-1211
![Page 5: Overnight Closed-Loop Insulin Delivery in Young People With Type 1 Diabetes: A Free- Living, Randomized Clinical Trial Featured Article: Roman Hovorka,](https://reader036.vdocuments.site/reader036/viewer/2022062515/56649f445503460f94c652ed/html5/thumbnails/5.jpg)
RESULTS
• Closed loop was constantly applied over at least 4 h on 269 nights (80%)
• Sensor data were collected over at least 4 h on 282 control nights (84%)
• Closed loop increased time spent with glucose in target by a median 15%
• Mean overnight glucose was reduced by a mean 14 mg/dL
Hovorka R. et al. Diabetes Care 2014;37:1204-1211
![Page 6: Overnight Closed-Loop Insulin Delivery in Young People With Type 1 Diabetes: A Free- Living, Randomized Clinical Trial Featured Article: Roman Hovorka,](https://reader036.vdocuments.site/reader036/viewer/2022062515/56649f445503460f94c652ed/html5/thumbnails/6.jpg)
RESULTS
• Time when glucose was <70 mg/dL was low in both groups, but nights with glucose <63 mg/dL for at least 20 min were less frequent during closed loop
• Despite lower total daily insulin doses by a median 2.3 units, overall 24-h glucose was reduced by a mean 9 mg/dL during closed loop
Hovorka R. et al. Diabetes Care 2014;37:1204-1211
![Page 7: Overnight Closed-Loop Insulin Delivery in Young People With Type 1 Diabetes: A Free- Living, Randomized Clinical Trial Featured Article: Roman Hovorka,](https://reader036.vdocuments.site/reader036/viewer/2022062515/56649f445503460f94c652ed/html5/thumbnails/7.jpg)
CONCLUSIONS
• Unsupervised home use of overnight closed loop in adolescents with type 1 diabetes is safe and feasible
• Glucose control was improved during the day and night with fewer episodes of nocturnal hypoglycemia
Hovorka R. et al. Diabetes Care 2014;37:1204-1211
![Page 8: Overnight Closed-Loop Insulin Delivery in Young People With Type 1 Diabetes: A Free- Living, Randomized Clinical Trial Featured Article: Roman Hovorka,](https://reader036.vdocuments.site/reader036/viewer/2022062515/56649f445503460f94c652ed/html5/thumbnails/8.jpg)
Hovorka R. et al. Diabetes Care 2014;37:1204-1211
![Page 9: Overnight Closed-Loop Insulin Delivery in Young People With Type 1 Diabetes: A Free- Living, Randomized Clinical Trial Featured Article: Roman Hovorka,](https://reader036.vdocuments.site/reader036/viewer/2022062515/56649f445503460f94c652ed/html5/thumbnails/9.jpg)
Hovorka R. et al. Diabetes Care 2014;37:1204-1211
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Hovorka R. et al. Diabetes Care 2014;37:1204-1211