Trial reportCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2013
Glucose-responsive insulin and glucagon delivery (dual-hormone artificial pancreas) in adults with type 1 diabetes: a randomized crossover controlled trial.
Trial report in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01297946 (An Open-label, Randomized, Two-way, Cross-over Study to Assess the Efficacy of Dual-hormone Closed-loop Strategy as Compared to Conventional CSII Therapy in Regulating Glucose Levels in Adults With Type-1 Diabetes in the Context of Exercise), which is not on this map. Cited by 64 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
An Open-label, Randomized, Two-way, Cross-over Study to Assess the Efficacy of Dual-hormone Closed-loop Strategy as Compared to Conventional CSII Therapy in Regulating Glucose Levels in Adults With Type-1 Diabetes in the Context of Exercise
Who cites it
64 citing papers in PubMed, 3 syntheses or guidelines pooled it, 166 citations in OpenAlex.
- Low-Dose Glucagon to Prevent and Treat Exercise-Associated Hypoglycemia in Individuals With Type 1 Diabetes: A Systematic Review and Meta-analysis.Diabetes care · 2025Pooled it
- Dual-hormone artificial pancreas for glucose control in type 1 diabetes: A meta-analysis.Diabetes, obesity & metabolism · 2022Pooled it
- Identification of Main Factors Explaining Glucose Dynamics During and Immediately After Moderate Exercise in Patients With Type 1 Diabetes.Journal of diabetes science and technology · 2015Pooled it
- Trial
- Postprandial metabolic effects of fructose and glucose in type 1 diabetes patients: a pilot randomized crossover clinical trial.Archives of endocrinology and metabolism · 2019Trial
- Analyzing the Potential of Advanced Insulin Dosing Strategies in Patients With Type 2 Diabetes: Results From a Hybrid In Silico Study.Journal of diabetes science and technology · 2018Trial
- Impact of erroneous meal insulin bolus with dual-hormone artificial pancreas using a simplified bolus strategy - A randomized controlled trial.Scientific reports · 2018Trial
- Trial
- Hypoglycemia Detection and Carbohydrate Suggestion in an Artificial Pancreas.Journal of diabetes science and technology · 2016Trial
- Mitigating Meal-Related Glycemic Excursions in an Insulin-Sparing Manner During Closed-Loop Insulin Delivery: The Beneficial Effects of Adjunctive Pramlintide and Liraglutide.Diabetes care · 2016Trial
- Hybrid Closed-Loop Insulin Delivery in Type 1 Diabetes During Supervised Outpatient Conditions.Journal of diabetes science and technology · 2016Trial
- Glucagon sensitivity and clearance in type 1 diabetes: insights from in vivo and in silico experiments.American journal of physiology. Endocrinology and metabolism · 2015Trial
- Quantification of the glycemic response to microdoses of subcutaneous glucagon at varying insulin levels.Diabetes care · 2014Trial
- Trial
- Autonomous and continuous adaptation of a bihormonal bionic pancreas in adults and adolescents with type 1 diabetes.The Journal of clinical endocrinology and metabolism · 2014Trial
- Overnight closed-loop insulin delivery in young people with type 1 diabetes: a free-living, randomized clinical trial.Diabetes care · 2014Trial
- Model-based closed-loop glucose control in type 1 diabetes: the DiaCon experience.Journal of diabetes science and technology · 2013Trial
- A Human Glucoregulatory Model for the Rational Design and Evaluation of Diabetes Therapeutics.ACS pharmacology & translational science · 2026Article
- A Glucose-Responsive Glucagon-Micelle for the Prevention of Hypoglycemia.ACS central science · 2024Article
- Themes, Rates, and Risk of Adverse Events of the Artificial Pancreas in the United States Using MAUDE.Annals of biomedical engineering · 2024Article
4 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMost patients with type 1 diabetes do not achieve their glycemic targets. We aimed to assess the efficacy of glucose-responsive insulin and glucagon closed-loop delivery for controlling glucose levels in adults with type 1 diabetes.
methodsWe conducted a randomized crossover trial involving 15 adults with type 1 diabetes, comparing standard insulin-pump therapy with dual-hormone, closed-loop delivery. Patients were admitted twice to a clinical research facility and received, in random order, both treatments. Each 15-hour visit (from 1600 to 0700) included an evening exercise session, followed by a medium-sized meal, a bedtime snack and an overnight stay. During visits that involved closed-loop delivery, basal insulin and glucagon miniboluses were delivered according to recommendations based on glucose sensor readings and a predictive dosing algorithm at 10-minute intervals. During visits involving standard insulin-pump therapy (control visits), patients used conventional treatment.
resultsDual-hormone closed-loop delivery increased the percentage of time for which patients' plasma glucose levels were in the target range (median 70.7% [interquartile range (IQR) 46.1%-88.4%] for closed-loop delivery v. 57.3% [IQR 25.2%-71.8%] for control, p = 0.003) and decreased the percentage of time for which plasma glucose levels were in the low range (bottom of target range [< 4.0 mmol/L], 0.0% [IQR 0.0%-3.0%] for closed-loop delivery v. 10.2% [IQR 0.0%-13.0%] for control, p = 0.01; hypoglycemia threshold [< 3.3 mmol/L], 0.0% [IQR 0.0%-0.0%] for closed-loop delivery v. 2.8% [IQR 0.0%-5.9%] for control, p = 0.006). Eight participants (53%) had at least 1 hypoglycemic event (plasma glucose < 3.0 mmol/L) during standard treatment, compared with just 1 participant (7%) during closed-loop treatment (p = 0.02).
interpretationDual-hormone, closed-loop delivery guided by advanced algorithms improved short-term glucose control and reduced the risk of hypoglycemia in a group of 15 adults with type 1 diabetes.
trial registrationClinicalTrials.gov, no. NCT01297946.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.