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Diabetes Obes Metab. 2017 Oct;19(10):1485-1489. doi: 10.1111/dom.12956. Epub 2017 Jun 23.

Faster insulin action is associated with improved glycaemic outcomes during closed-loop insulin delivery and sensor-augmented pump therapy in adults with type 1 diabetes.

Author information

1
Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
2
Department of Paediatrics, University of Cambridge, Cambridge, UK.
3
Department of Diabetes & Endocrinology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
4
Profil, Neuss, Germany.
5
Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.

Abstract

We aimed to evaluate the relationship between insulin pharmacodynamics and glycaemic outcomes during closed-loop insulin delivery and sensor-augmented pump therapy. We retrospectively analysed data from a multicentre randomized control trial involving 32 adults with type 1 diabetes receiving day-and-night closed-loop insulin delivery and sensor-augmented pump therapy over 12 weeks. We estimated time-to-peak insulin action (t max,IA ) and insulin sensitivity ( S I ) during both interventions, and correlated these with demographic factors and glycaemic outcomes. During both interventions, t max,IA was positively correlated with pre- and post-intervention HbA1c (r = 0.50-0.52, P  < .01) and mean glucose (r = 0.45-0.62, P  < .05), and inversely correlated with time sensor glucose, which was in target range 3.9 to 10 mmol/L (r = -0.64 to -0.47, P  < .05). Increased body mass index was associated with higher t max,I and lower S I (both P  < .05). During closed-loop insulin delivery, t max,IA was positively correlated with glucose variability ( P  < .05). Faster insulin action is associated with improved glycaemic control during closed-loop insulin delivery and sensor-augmented pump therapy.

KEYWORDS:

CSII ; glycaemic control; insulin delivery; insulin pump therapy; pharmacodynamics; type 1 diabetes

PMID:
28371223
PMCID:
PMC5638091
DOI:
10.1111/dom.12956
[Indexed for MEDLINE]
Free PMC Article

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