Variability of Insulin Requirements Over 12 Weeks of Closed-Loop Insulin Delivery in Adults With Type 1 Diabetes

Yue Ruan; Hood Thabit; Lalantha Leelarathna; Sara Hartnell; Malgorzata E Willinska; Sibylle Dellweg; Carsten Benesch; Julia K Mader; Manuel Holzer; Harald Kojzar; Mark L Evans; Thomas R Pieber; Sabine Arnolds; Roman Hovorka; AP@home Consortium

doi:10.2337/dc15-2623

Variability of Insulin Requirements Over 12 Weeks of Closed-Loop Insulin Delivery in Adults With Type 1 Diabetes

Yue Ruan
, Hood Thabit
, Lalantha Leelarathna
, Sara Hartnell
, Malgorzata E Willinska
, Sibylle Dellweg
, Carsten Benesch
, Julia K Mader
, Manuel Holzer
, Harald Kojzar
, Mark L Evans
, Thomas R Pieber
, Sabine Arnolds
, Roman Hovorka
, AP@home Consortium

Division of Integrative Physiology

Medical University of Graz
University of Cambridge
Cambridge University Hospitals NHS Foundation Trust
Profil Institut fuer Stoffwechselforschung GmbH Neuss

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE: To quantify variability of insulin requirements during closed-loop insulin delivery.

RESEARCH DESIGN AND METHODS: We retrospectively analyzed overnight, daytime, and total daily insulin amounts delivered during a multicenter closed-loop trial involving 32 adults with type 1 diabetes. Participants applied hybrid day-and-night closed-loop insulin delivery under free-living home conditions over 12 weeks. The coefficient of variation was adopted to measure variability of insulin requirements in individual subjects.

RESULTS: Data were analyzed from 1,918 nights, 1,883 daytime periods and 1,564 total days characterized by closed-loop use over 85% of time. Variability of overnight insulin requirements (mean [SD] coefficient of variation 31% [4]) was nearly twice as high as variability of total daily requirements (17% [3], P < 0.001) and was also higher than variability of daytime insulin requirements (22% [4], P < 0.001).

CONCLUSIONS: Overnight insulin requirements were significantly more variable than daytime and total daily amounts. This may explain why some people with type 1 diabetes report frustrating variability in morning glycemia.

Original language	English
Pages (from-to)	830-2
Number of pages	3
Journal	Diabetes Care
Volume	39
Issue number	5
Early online date	10 Mar 2016
DOIs	https://doi.org/10.2337/dc15-2623
Publication status	Published - May 2016

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Adult
Blood Glucose
Cross-Over Studies
Diabetes Mellitus, Type 1
Female
Humans
Hypoglycemic Agents
Insulin
Insulin Infusion Systems
Male
Middle Aged
Retrospective Studies
Young Adult
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

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10.2337/dc15-2623

Cite this

Ruan, Y., Thabit, H., Leelarathna, L., Hartnell, S., Willinska, M. E., Dellweg, S., Benesch, C., Mader, J. K., Holzer, M., Kojzar, H., Evans, M. L., Pieber, T. R., Arnolds, S., Hovorka, R., & AP@home Consortium (2016). Variability of Insulin Requirements Over 12 Weeks of Closed-Loop Insulin Delivery in Adults With Type 1 Diabetes. Diabetes Care, 39(5), 830-2. https://doi.org/10.2337/dc15-2623

@article{9bfb01ae891e4719b5e4e18c55ccb35a,

title = "Variability of Insulin Requirements Over 12 Weeks of Closed-Loop Insulin Delivery in Adults With Type 1 Diabetes",

abstract = "OBJECTIVE: To quantify variability of insulin requirements during closed-loop insulin delivery.RESEARCH DESIGN AND METHODS: We retrospectively analyzed overnight, daytime, and total daily insulin amounts delivered during a multicenter closed-loop trial involving 32 adults with type 1 diabetes. Participants applied hybrid day-and-night closed-loop insulin delivery under free-living home conditions over 12 weeks. The coefficient of variation was adopted to measure variability of insulin requirements in individual subjects.RESULTS: Data were analyzed from 1,918 nights, 1,883 daytime periods and 1,564 total days characterized by closed-loop use over 85\% of time. Variability of overnight insulin requirements (mean [SD] coefficient of variation 31\% [4]) was nearly twice as high as variability of total daily requirements (17\% [3], P < 0.001) and was also higher than variability of daytime insulin requirements (22\% [4], P < 0.001).CONCLUSIONS: Overnight insulin requirements were significantly more variable than daytime and total daily amounts. This may explain why some people with type 1 diabetes report frustrating variability in morning glycemia.",

keywords = "Adult, Blood Glucose, Cross-Over Studies, Diabetes Mellitus, Type 1, Female, Humans, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Male, Middle Aged, Retrospective Studies, Young Adult, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't",

author = "Yue Ruan and Hood Thabit and Lalantha Leelarathna and Sara Hartnell and Willinska, \{Malgorzata E\} and Sibylle Dellweg and Carsten Benesch and Mader, \{Julia K\} and Manuel Holzer and Harald Kojzar and Evans, \{Mark L\} and Pieber, \{Thomas R\} and Sabine Arnolds and Roman Hovorka and \{AP@home Consortium\}",

note = "{\textcopyright} 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.",

year = "2016",

month = may,

doi = "10.2337/dc15-2623",

language = "English",

volume = "39",

pages = "830--2",

journal = "Diabetes Care",

issn = "0149-5992",

publisher = "American Diabetes Association Inc.",

number = "5",

}

Ruan, Y, Thabit, H, Leelarathna, L, Hartnell, S, Willinska, ME, Dellweg, S, Benesch, C, Mader, JK, Holzer, M, Kojzar, H, Evans, ML, Pieber, TR, Arnolds, S, Hovorka, R & AP@home Consortium 2016, 'Variability of Insulin Requirements Over 12 Weeks of Closed-Loop Insulin Delivery in Adults With Type 1 Diabetes', Diabetes Care, vol. 39, no. 5, pp. 830-2. https://doi.org/10.2337/dc15-2623

TY - JOUR

T1 - Variability of Insulin Requirements Over 12 Weeks of Closed-Loop Insulin Delivery in Adults With Type 1 Diabetes

AU - Ruan, Yue

AU - Thabit, Hood

AU - Leelarathna, Lalantha

AU - Hartnell, Sara

AU - Willinska, Malgorzata E

AU - Dellweg, Sibylle

AU - Benesch, Carsten

AU - Mader, Julia K

AU - Holzer, Manuel

AU - Kojzar, Harald

AU - Evans, Mark L

AU - Pieber, Thomas R

AU - Arnolds, Sabine

AU - Hovorka, Roman

AU - AP@home Consortium

PY - 2016/5

Y1 - 2016/5

N2 - OBJECTIVE: To quantify variability of insulin requirements during closed-loop insulin delivery.RESEARCH DESIGN AND METHODS: We retrospectively analyzed overnight, daytime, and total daily insulin amounts delivered during a multicenter closed-loop trial involving 32 adults with type 1 diabetes. Participants applied hybrid day-and-night closed-loop insulin delivery under free-living home conditions over 12 weeks. The coefficient of variation was adopted to measure variability of insulin requirements in individual subjects.RESULTS: Data were analyzed from 1,918 nights, 1,883 daytime periods and 1,564 total days characterized by closed-loop use over 85% of time. Variability of overnight insulin requirements (mean [SD] coefficient of variation 31% [4]) was nearly twice as high as variability of total daily requirements (17% [3], P < 0.001) and was also higher than variability of daytime insulin requirements (22% [4], P < 0.001).CONCLUSIONS: Overnight insulin requirements were significantly more variable than daytime and total daily amounts. This may explain why some people with type 1 diabetes report frustrating variability in morning glycemia.

AB - OBJECTIVE: To quantify variability of insulin requirements during closed-loop insulin delivery.RESEARCH DESIGN AND METHODS: We retrospectively analyzed overnight, daytime, and total daily insulin amounts delivered during a multicenter closed-loop trial involving 32 adults with type 1 diabetes. Participants applied hybrid day-and-night closed-loop insulin delivery under free-living home conditions over 12 weeks. The coefficient of variation was adopted to measure variability of insulin requirements in individual subjects.RESULTS: Data were analyzed from 1,918 nights, 1,883 daytime periods and 1,564 total days characterized by closed-loop use over 85% of time. Variability of overnight insulin requirements (mean [SD] coefficient of variation 31% [4]) was nearly twice as high as variability of total daily requirements (17% [3], P < 0.001) and was also higher than variability of daytime insulin requirements (22% [4], P < 0.001).CONCLUSIONS: Overnight insulin requirements were significantly more variable than daytime and total daily amounts. This may explain why some people with type 1 diabetes report frustrating variability in morning glycemia.

KW - Adult

KW - Blood Glucose

KW - Cross-Over Studies

KW - Diabetes Mellitus, Type 1

KW - Female

KW - Humans

KW - Hypoglycemic Agents

KW - Insulin

KW - Insulin Infusion Systems

KW - Male

KW - Middle Aged

KW - Retrospective Studies

KW - Young Adult

KW - Journal Article

KW - Multicenter Study

KW - Randomized Controlled Trial

KW - Research Support, Non-U.S. Gov't

U2 - 10.2337/dc15-2623

DO - 10.2337/dc15-2623

M3 - Article

C2 - 26965717

SN - 0149-5992

VL - 39

SP - 830

EP - 832

JO - Diabetes Care

JF - Diabetes Care

IS - 5

ER -

Variability of Insulin Requirements Over 12 Weeks of Closed-Loop Insulin Delivery in Adults With Type 1 Diabetes

Abstract

UN SDGs

Keywords

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