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Postprandial hyperglycaemia following insulin suspensions by the artificial pancreas: Implications for bolus calculators
Author(s) -
Major Sandrine,
El Fathi Anas,
Palisaitis Emilie,
Kearney Robert,
Von Oettingen Julia E.,
Krishnamoorthy Preetha,
Legault Laurent,
Haidar Ahmad
Publication year - 2020
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.14044
Subject(s) - postprandial , insulin , medicine , artificial pancreas , bolus (digestion) , meal , diabetes mellitus , endocrinology , type 1 diabetes
Conventional bolus calculators apply negative prandial corrections when premeal glucose levels are low. However, no study has evaluated the need for this negative correction with closed‐loop systems. We analysed data retrospectively from a cohort study evaluating a closed‐loop artificial pancreas system conducted in a diabetes camp over a period of 11 days. Meal boluses with negative correction (n = 98) of 47 participants aged 8 to 22 years were examined. If there was no insulin‐on‐board from previous boluses at mealtime, the postprandial hyperglycaemia rate increased with increased duration of insulin suspension ( P = .03), with odds ratios being exaggerated by 17% per 10 minutes of suspension. However, if there was insulin‐on‐board from previous boluses, the hyperglycaemia rate did not change with increased duration of insulin suspension ( P = .24). When there was no insulin‐on‐board, the rate of hyperglycaemia after meals preceded by no suspension was 21% (3/14), compared with 52% (12/23) and 64% (9/14) after meals preceded by suspensions of ≥50 and ≥70 minutes, respectively. Meal size did not influence these results. We conclude that, in the absence of insulin‐on‐board, negative prandial corrections may not be necessary following long insulin suspensions.