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Faster insulin action is associated with improved glycaemic outcomes during closed‐loop insulin delivery and sensor‐augmented pump therapy in adults with type 1 diabetes
Author(s) -
Ruan Yue,
Thabit Hood,
Leelarathna Lalantha,
Hartnell Sara,
Wilinska Malgorzata E.,
Tauschmann Martin,
Dellweg Sibylle,
Benesch Carsten,
Mader Julia K.,
Holzer Manuel,
Kojzar Harald,
Evans Mark L.,
Pieber Thomas R.,
Arnolds Sabine,
Hovorka Roman
Publication year - 2017
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12956
Subject(s) - insulin , medicine , insulin pump , type 1 diabetes , diabetes mellitus , insulin delivery , endocrinology , type 2 diabetes , body mass index , closed loop , insulin sensitivity , randomized controlled trial , insulin resistance , control engineering , engineering
We aimed to evaluate the relationship between insulin pharmacodynamics and glycaemic outcomes during closed‐loop insulin delivery and sensor‐augmented pump therapy. We retrospectively analysed data from a multicentre randomized control trial involving 32 adults with type 1 diabetes receiving day‐and‐night closed‐loop insulin delivery and sensor‐augmented pump therapy over 12 weeks. We estimated time‐to‐peak insulin action ( t max, IA ) and insulin sensitivity ( S I ) during both interventions, and correlated these with demographic factors and glycaemic outcomes. During both interventions, t max, IA was positively correlated with pre‐ and post‐intervention HbA1c ( r = 0.50‐0.52, P < .01) and mean glucose ( r = 0.45‐0.62, P < .05), and inversely correlated with time sensor glucose, which was in target range 3.9 to 10 mmol/L ( r = −0.64 to −0.47, P < .05). Increased body mass index was associated with higher t max, I and lower S I (both P < .05). During closed‐loop insulin delivery, t max, IA was positively correlated with glucose variability ( P < .05). Faster insulin action is associated with improved glycaemic control during closed‐loop insulin delivery and sensor‐augmented pump therapy.