Author/Editor		Phillip, Moshe; Battelino, Tadej; Bratina, Nataša; Avbelj, Magdalena
Title		Nocturnal glucose control with an artificial pancreas at a diabetes camp
Type		članek
Vol. and No.		Letnik 368, št. 9
Publication year		2013
Volume		str. 824-833
ISSN		0028-4793 - The New England journal of medicine
Language		eng
Abstract		BackgroundRecent studies have shown that an artificial-pancreas system can improve glucosecontrol and reduce nocturnal hypoglycemia. However, it is not known whether suchresults can be replicated in settings outside the hospital. MethodsIn this multicenter, multinational, randomized, crossover trial, we assessed the shorttermsafety and efficacy of an artificial pancreas system for control of nocturnalglucose levels in patients (10 to 18 years of age) with type 1 diabetes at a diabetescamp. In two consecutive overnight sessions, we randomly assigned 56 patients to receivetreatment with an artificial pancreas on the first night and a sensor-augmentedinsulin pump (control) on the second night or to the reverse order of therapies on thefirst and second nights. Thus, all the patients received each treatment in a randomlyassigned order. The primary end points were the number of hypoglycemic events(defined as a sensor glucose value of <63 mg per deciliter [3.5 mmol per liter] forat least 10 consecutive minutes), the time spent with glucose levels below 60 mgper deciliter (3.3 mmol per liter), and the mean overnight glucose level for individualpatients. ResultsOn nights when the artificial pancreas was used, versus nights when the sensoraugmentedinsulin pump was used, there were significantly fewer episodes ofnighttime glucose levels below 63 mg per deciliter (7 vs. 22) and significantlyshorter periods when glucose levels were below 60 mg per deciliter (P = 0.003 andP = 0.02, respectively, after adjustment for multiplicity). Median values for the individualmean overnight glucose levels were 126.4 mg per deciliter (interquartilerange, 115.7 to 139.1 [7.0 mmol per liter; interquartile range, 6.4 to 7.7]) with theartificial pancreas and 140.4 mg per deciliter (interquartile range, 105.7 to 167.4[7.8 mmol per liter; interquartile range, 5.9 to 9.3]) with the sensor-augmentedpump. No serious adverse events were reported. ConclusionsPatients at a diabetes camp who were treated with an artificial-pancreas systemhad less nocturnal hypoglycemia and tighter glucose control than when theywere treated with a sensor-augmented insulin pump.
Keywords		glucose control artificial pancreas