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Pediatr Diabetes. 2018 May;19(3):420-428. doi: 10.1111/pedi.12603. Epub 2017 Nov 20.

Predictive hyperglycemia and hypoglycemia minimization: In-home double-blind randomized controlled evaluation in children and young adolescents.

Author information

1
Department of Pediatric Endocrinology, Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Denver, Colorado.
2
Jaeb Center for Health Research, Tampa, Florida.
3
Rensselaer Polytechnic Institute, Troy, New York.
4
Department of Pediatric Endocrinology, Stanford University, Palo Alto, California.

Abstract

OBJECTIVE:

The primary objective of this trial was to evaluate the feasibility, safety, and efficacy of a predictive hyperglycemia and hypoglycemia minimization (PHHM) system vs predictive low glucose suspension (PLGS) alone in optimizing overnight glucose control in children 6 to 14 years old.

RESEARCH DESIGN AND METHODS:

Twenty-eight participants 6 to 14 years old with T1D duration ≥1 year with daily insulin therapy ≥12 months and on insulin pump therapy for ≥6 months were randomized per night into PHHM mode or PLGS-only mode for 42 nights. The primary outcome was percentage of time in sensor-measured range 70 to 180 mg/dL in the overnight period.

RESULTS:

The addition of automated insulin delivery with PHHM increased time in target range (70-180 mg/dL) from 66 ± 11% during PLGS nights to 76 ± 9% during PHHM nights (P<.001), without increasing hypoglycemia as measured by time below various thresholds. Average morning blood glucose improved from 176 ± 28 mg/dL following PLGS nights to 154 ± 19 mg/dL following PHHM nights (P<.001).

CONCLUSIONS:

The PHHM system was effective in optimizing overnight glycemic control, significantly increasing time in range, lowering mean glucose, and decreasing glycemic variability compared to PLGS alone in children 6 to 14 years old.

KEYWORDS:

automated insulin delivery; continuous glucose monitoring; type 1 diabetes

PMID:
29159870
DOI:
10.1111/pedi.12603
[Indexed for MEDLINE]
Free PMC Article

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