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Improving IV Insulin Administration in a Community Hospital

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An Automated Insulin Delivery System with Automatic Meal Bolus Based on a Hand-Gesturing Algorithm.

Anirban Roy¹, Benyamin Grosman¹, Andrea Benedetti¹

¹Medtronic Diabetes, Northridge, California, USA.

Diabetes Technology & Therapeutics

|February 28, 2024

Summary

A new hands-free closed-loop system for type 1 diabetes (T1D) management showed similar glycemic control to traditional methods. This automated insulin delivery system may reduce daily burdens for T1D patients, potentially improving their quality of life.

Keywords:

Automated insulin delivery system Automatic meal bolus Hands-free closed-loop system Type 1 diabetes

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Area of Science:

Endocrinology
Biomedical Engineering
Diabetes Technology

Background:

Type 1 diabetes (T1D) management requires significant daily effort, including carbohydrate counting and meal announcements.
Automated insulin delivery systems aim to reduce this burden and improve glycemic control.

Purpose of the Study:

To assess the feasibility and safety of a hands-free closed-loop (HFCL) system in adults with T1D.
To compare glycemic control using the HFCL system with and without manual meal announcements.

Main Methods:

A 10-day feasibility trial involving 17 adults with T1D using the MiniMed™ 780G pump and a smartwatch-based Klue application.
Participants experienced a 5-day home-stay phase (traditional carbohydrate counting) followed by a 5-day hotel-stay phase (HFCL system with automatic bolusing).
Standardized test meals were consumed in both phases to compare glycemic metrics.

Main Results:

Overall time in range (70-180 mg/dL) was comparable between the home-stay (83.4%) and hotel-stay (80.6%) phases.
No significant differences were observed in time below 70 mg/dL (3.1% vs. 3.0%) or above 180 mg/dL (13.5% vs. 16.3%).
The system was safe, with no severe hypoglycemia or diabetic ketoacidosis, though accommodating high-carbohydrate meals had limitations.

Conclusions:

The HFCL system demonstrated safety and maintained glycemic control comparable to traditional methods in adults with T1D.
Eliminating carbohydrate counting and manual meal announcements may enhance the quality of life for individuals managing T1D.
Further research is warranted to optimize the system's performance, particularly for high-carbohydrate meals.