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Excellent Glycemic Control Maintained by Open-Source Hybrid Closed-Loop AndroidAPS During and After Sustained

Lenka Petruzelkova1, Jan Soupal2, Veronika Plasova1

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Diabetes Technology & Therapeutics
|October 5, 2018
PubMed
Summary

Open-source AndroidAPS systems offer a safe and feasible alternative for glucose control in children during extreme sports, showing lower average glucose levels compared to commercial systems. Further research is needed to optimize performance and address system malfunctions.

Keywords:
AndroidAPSDo-it-yourself systems.Open-source hybrid closed loop

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Area of Science:

  • Pediatric Endocrinology
  • Biomedical Engineering
  • Diabetes Technology

Background:

  • Licensed hybrid closed-loop systems for diabetes management are not universally available.
  • Open-source hybrid closed-loop systems, such as AndroidAPS, are gaining popularity as alternatives.
  • Assessing these systems in challenging conditions like extreme sports is crucial for understanding their real-world applicability.

Purpose of the Study:

  • To evaluate the safety, feasibility, and efficacy of the open-source AndroidAPS system compared to the commercial SmartGuard technology.
  • To assess glucose control in children with type 1 diabetes participating in winter sports (alpine skiing).
  • To compare glycemic outcomes, including mean glucose levels, time below range, and time in range, between the two systems.

Main Methods:

  • A winter sports camp study involving 22 children (ages 6-15) with type 1 diabetes.
  • Participants were divided into two groups: one using AndroidAPS and the other using SmartGuard.
  • Primary endpoints included mean glucose level, time below 3.9 mmol/L, and time within the 3.9-10 mmol/L target range during alpine skiing.

Main Results:

  • The AndroidAPS group demonstrated significantly lower mean glycemia levels compared to the SmartGuard group (7.2 vs. 7.7 mmol/L).
  • No significant differences were observed in time below or within the target glucose range between the two systems.
  • The AndroidAPS group experienced more frequent cannula set malfunctions, although no severe hypoglycemia or serious adverse events occurred in either group.

Conclusions:

  • The open-source AndroidAPS system proved to be a safe and feasible option for glucose control in children during demanding physical activity.
  • While showing potential for improved glycemic control, further investigation into system reliability and malfunction rates is warranted.
  • AndroidAPS represents a viable alternative for diabetes management, particularly where commercial systems are unavailable or unsuitable.