Article ; Online: Postprandial hyperglycaemia following insulin suspensions by the artificial pancreas: Implications for bolus calculators.
Diabetes, obesity & metabolism
2020 Volume 22, Issue 8, Page(s) 1474–1477
Abstract: Conventional bolus calculators apply negative prandial corrections when premeal glucose levels are low. However, no study has evaluated the need for this negative correction with closed-loop systems. We analysed data retrospectively from a cohort study ... ...
Abstract | Conventional bolus calculators apply negative prandial corrections when premeal glucose levels are low. However, no study has evaluated the need for this negative correction with closed-loop systems. We analysed data retrospectively from a cohort study evaluating a closed-loop artificial pancreas system conducted in a diabetes camp over a period of 11 days. Meal boluses with negative correction (n = 98) of 47 participants aged 8 to 22 years were examined. If there was no insulin-on-board from previous boluses at mealtime, the postprandial hyperglycaemia rate increased with increased duration of insulin suspension (P = .03), with odds ratios being exaggerated by 17% per 10 minutes of suspension. However, if there was insulin-on-board from previous boluses, the hyperglycaemia rate did not change with increased duration of insulin suspension (P = .24). When there was no insulin-on-board, the rate of hyperglycaemia after meals preceded by no suspension was 21% (3/14), compared with 52% (12/23) and 64% (9/14) after meals preceded by suspensions of ≥50 and ≥70 minutes, respectively. Meal size did not influence these results. We conclude that, in the absence of insulin-on-board, negative prandial corrections may not be necessary following long insulin suspensions. |
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MeSH term(s) | Algorithms ; Blood Glucose ; Cohort Studies ; Diabetes Mellitus, Type 1/drug therapy ; Humans ; Hyperglycemia/drug therapy ; Hyperglycemia/prevention & control ; Hypoglycemic Agents/therapeutic use ; Insulin/therapeutic use ; Insulin Infusion Systems ; Pancreas, Artificial ; Postprandial Period ; Retrospective Studies ; Suspensions |
Chemical Substances | Blood Glucose ; Hypoglycemic Agents ; Insulin ; Suspensions |
Language | English |
Publishing date | 2020-06-13 |
Publishing country | England |
Document type | Journal Article ; Research Support, Non-U.S. Gov't |
ZDB-ID | 1454944-x |
ISSN | 1463-1326 ; 1462-8902 |
ISSN (online) | 1463-1326 |
ISSN | 1462-8902 |
DOI | 10.1111/dom.14044 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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