Multicenter outpatient dinner/overnight reduction of hypoglycemia and increased time of glucose in target with a wearable artificial pancreas using modular model predictive control in adults with type 1 diabetes

摘要: Aims To test in an outpatient setting the safety and efficacy of continuous subcutaneous insulin infusion (CSII) driven by a modular model predictive control (MMPC) algorithm informed glucose monitoring (CGM) measurement. Methods 13 patients affected type 1 diabetes participated to non-randomized 42-h experiment that included two evening meals overnight periods (in short, dinner & night periods). CSII was patient-driven during dinner & night period MMPC-driven dinnern Dexcom Inc., San Diego, CA, USA) pump (AccuChek Combo; Roche Diagnostics, Mannheim, Germany) were connected wirelessly smartphone-based platform (DiAs, Diabetes Assistant; University Virginia, Charlottesville, VA, both periods. Results A significantly lower percentage time spent with levels <3.9 mmol/l achieved 2 compared 1: 1.96 ± 4.56% vs 12.76 ± 15.84% (mean ± standard deviation, p < 0.01), together greater 3.9–10 mmol/l target range: 83.56 ± 14.02% 62.43 ± 29.03% (p = 0.04). In addition, restricting analysis phases, (1.92 ± 4.89% 12.7 ± 19.75%; p = 0.03) combined range (92.16 ± 8.03% 63.97 ± 2.73%; p = 0.01). Average levels similar periods. Conclusions The results suggest MMPC managed wearable system is safe effective meal overnight. Its sustained use this currently being tested ongoing randomized 2-month study.