Journal
DIABETES TECHNOLOGY & THERAPEUTICS
Volume 15, Issue 5, Pages 401-408Publisher
MARY ANN LIEBERT INC
DOI: 10.1089/dia.2013.0002
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Funding
- National Institutes of Health/Eunice Kennedy Shriver National Institute of Child Health and Human Development [HD41890-10, HD41906-10, HD41908-10, U01DK085509, U01DK06104211, 5U01DK085466-05, U01DK085505-02, 5U01DK085465-04]
- National Institutes of Health through the National Institute of Diabetes and Digestive and Kidney Diseases
- National Institute of Allergy and Infectious Diseases
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- National Center for Research Resources
- Juvenile Diabetes Research Foundation International
- American Diabetes Association
- Barbara Davis Center for Childhood Diabetes
- University of Colorado School of Medicine
- CTRC [1UL1 RR025780]
- National Center for Research Resources, National Institutes of Health [SUL1 RR025744]
- National Center for Research Resources, National Institutes of Health
- National Center of Research Resources [UL1 RR024139]
- National Institutes of Health
- National Institutes of Health Roadmap for Medical Research
- National Center for Advancing Translational Sciences [UL1TR000445]
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Background: This article describes our experience with inpatient hybrid closed-loop control (HCLC) initiated shortly after the diagnosis of type 1 diabetes in a randomized trial designed to assess the effectiveness of inpatient HCLC followed by outpatient sensor-augmented pump (SAP) therapy on the preservation of beta-cell function. Subjects and Methods: Forty-eight individuals with newly diagnosed type 1 diabetes and positive pancreatic autoantibodies (7.8-37.7 years old) received inpatient HCLC therapy for up to 93 h, initiated within 7 days of diagnosis. Results: On initiation of HCLC, mean glucose concentration was 240 +/- 100 mg/dL. During the first day of HCLC, median of the participant's mean glucose concentrations fell rapidly to 146 mg/dL, a level of control that was sustained on Days 2 and 3 (138 mg/dL and 139 mg/dL, respectively). By Day 3, the median percentage of glucose values >250 and <60 mg/dL was <1%. During the first 2 weeks of SAP treatment at home, the median participant mean glucose level was 126 mg/dL (interquartile range, 117, 137 mg/dL), and the median percentage of values between 71 and 180 mg/dL was 85% (interquartile range, 80%, 90%). Conclusions: Inpatient HCLC followed by outpatient SAP therapy can provide a safe and effective means to rapidly reverse glucose toxicity and establish near-normal glycemic control in patients with newly diagnosed type 1 diabetes.
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