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Glycemia, treatment satisfaction, cognition, and sleep quality in adults and adolescents with type 1 diabetes when using a closed-loop system overnight versus sensor-augmented pump with low-glucose suspend function: a randomized crossover study

Sharifi, Amin, De Bock, Martin I., Jayawardene, Dilshani, Loh, Margaret M., Horsburgh, Jodie C., Berthold, Carolyn L., Paramalingam, Nirubasini, Bach, Leon A., Colman, Peter G., Davis, Elizabeth A., Grosman, Benyamin, Hendrieckx, Christel, Jenkins, Alicia J., Kumareswaran, Kavita, Kurtz, Natalie, Kyoong, Andrew, MacIsaac, Richard J., Speight, Jane, Trawley, Steven, Ward, Glenn M., Roy, Anirban, Jones, Timothy W. and O'Neal, David N. 2016, Glycemia, treatment satisfaction, cognition, and sleep quality in adults and adolescents with type 1 diabetes when using a closed-loop system overnight versus sensor-augmented pump with low-glucose suspend function: a randomized crossover study, Diabetes technology and therapeutics, vol. 18, no. 12, pp. 772-783, doi: 10.1089/dia.2016.0288.

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Title Glycemia, treatment satisfaction, cognition, and sleep quality in adults and adolescents with type 1 diabetes when using a closed-loop system overnight versus sensor-augmented pump with low-glucose suspend function: a randomized crossover study
Author(s) Sharifi, Amin
De Bock, Martin I.
Jayawardene, Dilshani
Loh, Margaret M.
Horsburgh, Jodie C.
Berthold, Carolyn L.
Paramalingam, Nirubasini
Bach, Leon A.
Colman, Peter G.
Davis, Elizabeth A.
Grosman, Benyamin
Hendrieckx, Christel
Jenkins, Alicia J.
Kumareswaran, Kavita
Kurtz, Natalie
Kyoong, Andrew
MacIsaac, Richard J.
Speight, JaneORCID iD for Speight, Jane orcid.org/0000-0002-1204-6896
Trawley, StevenORCID iD for Trawley, Steven orcid.org/0000-0002-0917-730X
Ward, Glenn M.
Roy, Anirban
Jones, Timothy W.
O'Neal, David N.
Journal name Diabetes technology and therapeutics
Volume number 18
Issue number 12
Start page 772
End page 783
Total pages 12
Publisher Mary Ann Liebert
Place of publication New York, N.Y.
Publication date 2016-12
ISSN 1557-8593
Keyword(s) Artificial pancreas
Closed loop
Continuous subcutaneous insulin infusion
Insulin pumps
Type 1 diabetes
Summary BACKGROUND: We compared glycemia, treatment satisfaction, sleep quality, and cognition using a nighttime Android-based hybrid closed-loop system (Android-HCLS) with sensor-augmented pump with low-glucose suspend function (SAP-LGS) in people with type 1 diabetes.

MATERIALS AND METHODS: An open-label, prospective, randomized crossover study of 16 adults (mean [SD] age 42.1 [9.6] years) and 12 adolescents (15.2 [1.6] years) was conducted. All participants completed four consecutive nights at home with Android-HCLS (proportional integral derivative with insulin feedback algorithm; Medtronic) and SAP-LGS.

PRIMARY OUTCOME: percent continuous glucose monitoring (CGM) time (00:00-08:00 h) within target range (72-144 mg/dL). Secondary endpoints: percent CGM time above target (>144 mg/dL); below target (<72 mg/dL); glycemic variability (SD); symptomatic hypoglycemia; adult treatment satisfaction; sleep quality; and cognitive function.

RESULTS: The primary outcome for all participants was not statistically different between Android-HCLS and SAP-LGS (mean [SD] 59.4 [17.9]% vs. 53.1 [18]%; p = 0.14). Adults had greater percent time within target range (57.7 [18.6]% vs. 44.5 [14.5]%; p < 0.006); less time above target (42.0 [18.7]% vs. 52.6 [16.5]%; p = 0.034); lower glycemic variability (35 [10.7] mg/dL vs. 46 [10.7] mg/dL; p = 0.003); and less (median [IQR]) time below target (0.0 [0.0-0.4]% vs. 0.80 [0.0-3.9]%; p = 0.025). In adolescents, time below target was lower with Android-HCLS vs. SAP-LGS (0.0 [0.0-0.0]% vs. 1.8 [0.1-7.9]%; p = 0.011). Nocturnal symptomatic hypoglycemia was less (1 vs. 10; p = 0.007) in adolescents, but not adults (5 vs. 13; p = 0.059). In adults, treatment satisfaction increased by 10 points (p < 0.02). Sleep quality and cognition did not differ.

CONCLUSIONS: Android-HCLS in both adults and adolescents reduced nocturnal hypoglycemia and, in adults, improved overnight time in target range and treatment satisfaction compared with SAP-LGS.
Language eng
DOI 10.1089/dia.2016.0288
Field of Research 170106 Health, Clinical and Counselling Psychology
Socio Economic Objective 920104 Diabetes
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Mary Ann Liebert
Persistent URL http://hdl.handle.net/10536/DRO/DU:30090631

Document type: Journal Article
Collection: School of Psychology
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