Post-breakfast closed-loop glucose control is improved when accompanied with carbohydrate-matching bolus compared to weight-dependent bolus - 17/06/14

Doi : 10.1016/j.diabet.2013.12.001

A. Haidar ^a,^⁎,^g,^{^{1
Equal contribution.}} , D. Farid ^a,^g,^{^{1
Equal contribution.}}, A. St-Yves ^a,^{^{1
Equal contribution.}}, V. Messier ^a, V. Chen ^b, D. Xing ^b, A.-S. Brazeau ^a, C. Duval ^a, B. Boulet ^c, L. Legault ^d, R. Rabasa-Lhoret ^a,^e,^f
^a Institut de Recherches Cliniques de Montréal, Montreal, Canada
^b Jaeb Center for Health Research, Tampa, FL, USA
^c Centre for Intelligent Machines, McGill University, Montreal, Canada
^d Montreal Children's Hospital, McGill University Health Centre, Montreal, Canada
^e Nutrition department, Faculty of medicine, Université de Montréal, Montreal, Canada
^f Montreal diabetes research center, Montreal, Canada
^g Experimental Medicine, McGill University, Montreal, Canada

^⁎Corresponding author. Institut de Recherches Cliniques de Montréal, 110, des Pins West, H2W 1R7, Montreal, Canada. Tel.: +514 987 5500x3238; fax: +514 987 5670.

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Abstract

Aim

We compared post-breakfast closed-loop glucose control either matched with a carbohydrate-matching bolus or a weight-dependent bolus.

Methods

Twelve adults with type 1 diabetes consumed a 75g CHO breakfast on two occasions. In random order, the breakfast was accompanied by a full carbohydrate-matching insulin bolus (8.30U [7.50U–11.50U]) or a partial weight-dependent insulin bolus (0.047U/kg; 3.45U [2.95U–3.75U]). Postprandial glucose was regulated by sensor-responsive insulin and glucagon delivery.

Results

Glucose control after the weight-dependent bolus was safe and feasible (glucose values returned to pre-prandial levels after 5h). However, 5-hr incremental area under the curve and percentage of time above 10mmol/L were lower after the full bolus compared to the partial bolus (IAUC, 2.1 [0.8–4.2]mmol/L/hr vs 8.3 [6.5–11.4] mmol/L/hr; time in hyperglycaemia, 24% [6%–29%] vs 50% [25%–63%]; P<0.001).

Conclusions

Post-breakfast closed-loop glucose control without carbohydrate counting, but based on weight-dependent bolus is feasible but a carbohydrate-matching bolus provides better glucose control.

Clinical trial registry

NCT01519102

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Keywords : Type 1 diabetes, Closed-loop delivery, Postprandial control, Glucagon, Artificial pancreas

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Vol 40 - N° 3

P. 211-214 - juin 2014 Retour au numéro

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Post-breakfast closed-loop glucose control is improved when accompanied with carbohydrate-matching bolus compared to weight-dependent bolus - 17/06/14

Abstract

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Methods

Results

Conclusions

Clinical trial registry

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