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Published on: June 11, 2012
Variability of Insulin Requirements Over 12 Weeks of Closed-Loop Insulin Delivery in Adults With Type 1 Diabetes
Yue Ruan1, Hood Thabit2, Lalantha Leelarathna2
1Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, U.K. Department of Paediatrics, University of Cambridge, Cambridge, U.K.
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.
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