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Diabetes Technol Ther. 2012 Aug;14(8):728-35. doi: 10.1089/dia.2012.0004.

Feasibility study of automated overnight closed-loop glucose control under MD-logic artificial pancreas in patients with type 1 diabetes: the DREAM Project.

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  • 1Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, The National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, 14 Kaplan St., Petah Tikva, Israel .

Abstract

BACKGROUND:

Artificial pancreas systems may offer a potential major impact on the normalization of metabolic control and preventing hypoglycemic events. This study aims to establish near-normal overnight glucose control and reduce the risk of nocturnal hypoglycemia using the MD-Logic Artificial Pancreas (MDLAP), an algorithm that was developed by our research group. This inpatient feasibility study is the first step towards implementing an overnight closed-loop MDLAP system at the patient's home.

SUBJECTS AND METHODS:

Seven patients with type 1 diabetes (three adolescents and four adults; mean±SD age, 20.6±4.7 years; duration of diabetes, 9.6±2.6 years; body mass index, 24.3±3.9 kg/m(2); and glycated hemoglobin, 7.8±0.8%) participated in a total of 14 closed-loop overnight sessions. Each participant underwent two closed-loop inpatient sessions starting at dinner alone and at dinner following exercise. The closed-loop inpatient sessions were compared with data derived from nights spent at home with an open-loop system in a similar scenario to the study protocol.

RESULTS:

The mean percentage of time spent in the near normal glucose range of 63-140 mg/dL was 83±16%, and the median (interquartile range) was 85% (78-92%) for the overnight closed-loop sessions compared with 34±31% and 27% (6-57%) in the homecare open-loop setting, respectively. During the overnight closed-loop sessions at dinner alone 92±9% of the sensor values ranged within target range, compared with 73±19% for the sessions following exercise (P=0.03). No hypoglycemic (<63 mg/dL) events occurred during the closed-loop sessions.

CONCLUSION:

Closed-loop insulin delivery under MDLAP is a feasible and safe solution to control overnight glycemia.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00541515.

PMID:
22853723
[PubMed - indexed for MEDLINE]
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