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Diabetes Technol Ther. 2013 May;15(5):401-8. doi: 10.1089/dia.2013.0002. Epub 2013 Apr 9.

The effects of inpatient hybrid closed-loop therapy initiated within 1 week of type 1 diabetes diagnosis.

Collaborators (142)

Tsalikian E, Tansey MJ, Coffey J, Cabbage J, Salamati S, Mauras N, Fox LA, Englert K, Permuy J, Sikes K, Buckingham BA, Wilson DM, Clinton P, Caswell K, Weinzimer SA, Tamborlane WV, Sherr J, Steffen A, Weyman K, Zgorski M, Tichy E, White NH, Arbelaez AM, Levandoski L, Starnes A, Beck RW, Ruedy KJ, Kollman C, Xing D, Hall C, Stevens B, Grave GD, Winer K, Leschek E, Skyler JS, Greenbaum CJ, Kenyon NS, Rafkin L, Santiago I, Sosenko JM, Fradkin J, Leschek E, Savage P, Spain L, Blumberg E, Beck G, Braun J, Brillon D, Gubitosi-Klug R, Laffel L, Veatch R, Wallace D, Lernmark A, Lo B, Mitchell H, Naji A, Nerup J, Orchard T, Steffes M, Tsiatis A, Zinman B, Skyler JS, Anderson M, Atkinson M, Bourcier K, Becker D, Bingley P, Blum J, Bosi E, Buckner J, Chase HP, Clare-Salzler M, Colman P, DiMeglio LA, Eisenbarth GS, Fathman CG, Gitelman S, Goland R, Gottlieb P, Grave G, Greenbaum CJ, Hering B, Herold K, Insel R, Krischer JP, Marks J, Moran A, Palmer JP, Peakman M, Pugliese A, Raskin P, Roncarolo MG, Russell W, Savage P, Schatz D, Sherwin R, Siegelman M, Simell O, Thomas J, Trucco M, Wentworth J, Wherrett D, Wilson DM, Winter W, Fradkin J, Leschek E, Spain L, Benoist C, Bluestone J, Brown D, Cowie C, Harrison L, Jordan S, Kaufman FR, Lachin JM, Mahon J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Ridge J, Rodriguez H, Wagner J, Ziegler A, Skyler JS, Bourcier K, Greenbaum CJ, Krischer JP, Leschek E, Rafkin L, Savage P, Spain L, Cowie C, Foulkes M, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Zafonte SJ.

Abstract

BACKGROUND:

This article describes our experience with inpatient hybrid closed-loop control (HCLC) initiated shortly after the diagnosis of type 1 diabetes in a randomized trial designed to assess the effectiveness of inpatient HCLC followed by outpatient sensor-augmented pump (SAP) therapy on the preservation of β-cell function.

SUBJECTS AND METHODS:

Forty-eight individuals with newly diagnosed type 1 diabetes and positive pancreatic autoantibodies (7.8-37.7 years old) received inpatient HCLC therapy for up to 93 h, initiated within 7 days of diagnosis.

RESULTS:

On initiation of HCLC, mean glucose concentration was 240±100 mg/dL. During the first day of HCLC, median of the participant's mean glucose concentrations fell rapidly to 146 mg/dL, a level of control that was sustained on Days 2 and 3 (138 mg/dL and 139 mg/dL, respectively). By Day 3, the median percentage of glucose values >250 and <60 mg/dL was <1%. During the first 2 weeks of SAP treatment at home, the median participant mean glucose level was 126 mg/dL (interquartile range, 117, 137 mg/dL), and the median percentage of values between 71 and 180 mg/dL was 85% (interquartile range, 80%, 90%).

CONCLUSIONS:

Inpatient HCLC followed by outpatient SAP therapy can provide a safe and effective means to rapidly reverse glucose toxicity and establish near-normal glycemic control in patients with newly diagnosed type 1 diabetes.

PMID:
23570538
PMCID:
PMC3643224
DOI:
10.1089/dia.2013.0002
[Indexed for MEDLINE]
Free PMC Article
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