Evidence map›Paper›PMID 28767276›Full record

Trial reportDiabetes technology & therapeutics2017

Closed-Loop Control Without Meal Announcement in Type 1 Diabetes.

Faye M Cameron, Trang T Ly, Bruce A Buckingham, David M Maahs, Gregory P Forlenza, Carol J Levy, David Lam, Paula Clinton, Laurel H Messer, Emily Westfall and 6 more

Abstract readClinical TrialComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Diabetes technology & therapeutics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers.

0numbers the graph read from it
0cells of the map it votes in
46citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

46 citing papers in PubMed.

  1. Trial
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  9. Article
  10. Article
  11. Early Stages of Automated Insulin Delivery.Journal of diabetes science and technology · 2025
    Review
  12. Metabolic Models, in Silico Trials, and Algorithms.Journal of diabetes science and technology · 2025
    Review
  13. Early Stages of Automated Insulin Delivery.Diabetes technology & therapeutics · 2025
    Review
  14. Metabolic Models, in Silico Trials, and Algorithms.Diabetes technology & therapeutics · 2025
    Review
  15. Review
  16. Review
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Faye M Cameron1 Department of Chemical and Biological Engineering, Rensselaer Polytechnic Institute , Troy, New York.
Trang T Ly2 Department of Pediatric Endocrinology, Stanford University , Stanford, California.
Bruce A Buckingham2 Department of Pediatric Endocrinology, Stanford University , Stanford, California.
David M Maahs2 Department of Pediatric Endocrinology, Stanford University , Stanford, California.
Gregory P Forlenza3 Department of Pediatrics, Barbara Davis Center for Childhood Diabetes , Aurora, Colorado.
Carol J Levy4 Division of Endocrinology, Icahn School of Medicine at Mount Sinai , New York, New York.
David Lam4 Division of Endocrinology, Icahn School of Medicine at Mount Sinai , New York, New York.
Paula Clinton2 Department of Pediatric Endocrinology, Stanford University , Stanford, California.
Laurel H Messer3 Department of Pediatrics, Barbara Davis Center for Childhood Diabetes , Aurora, Colorado.
Emily Westfall3 Department of Pediatrics, Barbara Davis Center for Childhood Diabetes , Aurora, Colorado.
Camilla Levister4 Division of Endocrinology, Icahn School of Medicine at Mount Sinai , New York, New York.
Yan Yan Xie4 Division of Endocrinology, Icahn School of Medicine at Mount Sinai , New York, New York.
Nihat Baysal1 Department of Chemical and Biological Engineering, Rensselaer Polytechnic Institute , Troy, New York.
Daniel Howsmon1 Department of Chemical and Biological Engineering, Rensselaer Polytechnic Institute , Troy, New York.
Stephen D Patek5 Department of Systems and Information Engineering, University of Virginia , Charlottesville, Virginia.
B Wayne Bequette1 Department of Chemical and Biological Engineering, Rensselaer Polytechnic Institute , Troy, New York.

Funding

Translational Research CoreP30DK020541 · NIDDK · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI STREAMSON C CHUA · 2015 to 2026
$27.7M
A probabilistic closed-loop artificial pancreas to handle unannounced meals R01DK102188 · NIDDK · RENSSELAER POLYTECHNIC INSTITUTE · PI BEQUETTE, B. WAYNE, BUCKINGHAM, BRUCE A · 2014 to 2016
$1.0M
NIDDK NIH HHS P30 DK020541NIDDK NIH HHS R01 DK102188
6 · The paper itself

Abstract

objectiveA fully closed-loop insulin-only system was developed to provide glucose control in patients with type 1 diabetes without requiring announcement of meals or activity. Our goal was to assess initial safety and efficacy of this system. RESEARCH DESIGN AND

methodsThe multiple model probabilistic controller (MMPPC) anticipates meals when the patient is awake. The controller used the subject's basal rates and total daily insulin dose for initialization. The system was tested at two sites on 10 patients in a 30-h inpatient study, followed by 15 subjects at three sites in a 54-h supervised hotel study, where the controller was challenged by exercise and unannounced meals. The system was implemented on the UVA DiAs system using a Roche Spirit Combo Insulin Pump and a Dexcom G4 Continuous Glucose Monitor.

resultsThe mean overall (24-h basis) and nighttime (11 PM-7 AM) continuous glucose monitoring (CGM) values were 142 and 125 mg/dL during the inpatient study. The hotel study used a different daytime tuning and manual announcement, instead of automatic detection, of sleep and wake periods. This resulted in mean overall (24-h basis) and nighttime CGM values of 152 and 139 mg/dL for the hotel study and there was also a reduction in hypoglycemia events from 1.6 to 0.91 events/patient/day.

conclusionsThe MMPPC system achieved a mean glucose that would be particularly helpful for people with an elevated A1c as a result of frequent missed meal boluses. Current full closed loop has a higher risk for hypoglycemia when compared with algorithms using meal announcement.

Indexed as

MealsAccelerometryActivities of Daily LivingAdultAlgorithmsBlood GlucoseDiabetes Mellitus, Type 1ExerciseFeasibility StudiesFemaleFollow-Up StudiesHospitalizationHumansHyperglycemiaHypoglycemiaMaleBlood GlucoseArtificial pancreasClosed-loop systemsContinuous glucose monitoring.Postprandial blood glucose

Identifiers

PMID28767276
PMCPMC5647490

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.