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Featured Article :. Overnight Closed-Loop Insulin Delivery in Young People With Type 1 Diabetes: A Free-Living, Randomized Clinical Trial.

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Featured Article :

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  1. Featured Article: Overnight Closed-Loop Insulin Delivery in Young People With Type 1 Diabetes: A Free-Living, Randomized Clinical Trial Roman Hovorka, Daniela Elleri, Hood Thabit, Janet M. Allen, Lalantha Leelarathna, Ranna El-Khairi, Kavita Kumareswaran, Karen Caldwell, Peter Calhoun, Craig Kollman, Helen R. Murphy, Carlo L. Acerini, Malgorzata E. Wilinska, Marianna Nodale, and David B. Dunger Diabetes Care Volume 37: 1204-1211 May, 2014

  2. STUDY OBJECTIVE • To evaluate feasibility, safety, and efficacy of overnight closed-loop insulin delivery in free-living youth with type 1 diabetes Hovorka R. et al. Diabetes Care 2014;37:1204-1211

  3. STUDY DESIGN AND METHODS • Overnight closed loop was evaluated at home by 16 pump-treated adolescents with type 1 diabetes aged 12–18 years • Over a 3-week period, overnight insulin delivery was directed by a closed-loop system • On another 3-week period, sensor-augmented therapy was applied • Order of interventions was random • Primary end point was time when adjusted sensor glucose was between 3.9 and 8.0 mmol/L from 2300 to 0700 h Hovorka R. et al. Diabetes Care 2014;37:1204-1211

  4. Hovorka R. et al. Diabetes Care 2014;37:1204-1211

  5. RESULTS • Closed loop was constantly applied over at least 4 h on 269 nights (80%) • Sensor data were collected over at least 4 h on 282 control nights (84%) • Closed loop increased time spent with glucose in target by a median 15% • Mean overnight glucose was reduced by a mean 14 mg/dL Hovorka R. et al. Diabetes Care 2014;37:1204-1211

  6. RESULTS • Time when glucose was <70 mg/dL was low in both groups, but nights with glucose <63 mg/dL for at least 20 min were less frequent during closed loop • Despite lower total daily insulin doses by a median 2.3 units, overall 24-h glucose was reduced by a mean 9 mg/dL during closed loop Hovorka R. et al. Diabetes Care 2014;37:1204-1211

  7. CONCLUSIONS • Unsupervised home use of overnight closed loop in adolescents with type 1 diabetes is safe and feasible • Glucose control was improved during the day and night with fewer episodes of nocturnal hypoglycemia Hovorka R. et al. Diabetes Care 2014;37:1204-1211

  8. Hovorka R. et al. Diabetes Care 2014;37:1204-1211

  9. Hovorka R. et al. Diabetes Care 2014;37:1204-1211

  10. Hovorka R. et al. Diabetes Care 2014;37:1204-1211

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