In:
Journal of Diabetes Science and Technology, SAGE Publications, Vol. 18, No. 4 ( 2024-07), p. 882-888
Abstract:
Many hybrid closed-loop (HCL) systems struggle to manage unusually high glucose levels as experienced with intercurrent illness or pre-menstrually. Manual correction boluses may be needed, increasing hypoglycemia risk with overcorrection. The Cambridge HCL system includes a user-initiated algorithm intensification mode (“Boost”), activation of which increases automated insulin delivery by approximately 35%, while remaining glucose-responsive. In this analysis, we assessed the safety of “Boost” mode. Methods: We retrospectively analyzed data from closed-loop studies involving young children (1-7 years, n = 24), children and adolescents (10-17 years, n = 19), adults (≥24 years, n = 13), and older adults (≥60 years, n = 20) with type 1 diabetes. Outcomes were calculated per participant for days with ≥30 minutes of “Boost” use versus days with no “Boost” use. Participants with 〈 10 “Boost” days were excluded. The main outcome was time spent in hypoglycemia 〈 70 and 〈 54 mg/dL. Results: Eight weeks of data for 76 participants were analyzed. There was no difference in time spent 〈 70 and 〈 54 mg/dL between “Boost” days and “non-Boost” days; mean difference: –0.10% (95% confidence interval [CI] –0.28 to 0.07; P = .249) time 〈 70 mg/dL, and 0.03 (–0.04 to 0.09; P = .416) time 〈 54 mg/dL. Time in significant hyperglycemia 〉 300 mg/dL was 1.39 percentage points (1.01 to 1.77; P 〈 .001) higher on “Boost” days, with higher mean glucose and lower time in target range ( P 〈 .001). Conclusions: Use of an algorithm intensification mode in HCL therapy is safe across all age groups with type 1 diabetes. The higher time in hyperglycemia observed on “Boost” days suggests that users are more likely to use algorithm intensification on days with extreme hyperglycemic excursions.
Type of Medium:
Online Resource
ISSN:
1932-2968
,
1932-2968
DOI:
10.1177/19322968221141924
Language:
English
Publisher:
SAGE Publications
Publication Date:
2024
detail.hit.zdb_id:
2467312-2
