Evidence map›Paper›PMID 36475908›Full record

ArticleJournal of diabetes science and technology2024

Safety of User-Initiated Intensification of Insulin Delivery Using Cambridge Hybrid Closed-Loop Algorithm.

Julia Ware, Malgorzata E Wilinska, Yue Ruan, Janet M Allen, Charlotte K Boughton, Sara Hartnell, Lia Bally, Carine de Beaufort, Rachel E J Besser, Fiona M Campbell and 19 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of diabetes science and technology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

29 authors.

Julia WareMetabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK.ORCID 0000-0002-4497-0979
Malgorzata E WilinskaMetabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
Yue RuanMetabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
Janet M AllenMetabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
Charlotte K BoughtonMetabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK.ORCID 0000-0003-3272-9544
Sara HartnellDepartment of Diabetes and Endocrinology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Lia BallyDepartment of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, Bern, Switzerland.
Carine de BeaufortDiabetes & Endocrine Care Clinique Pediatrique, Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg.
Rachel E J BesserNIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.ORCID 0000-0002-4645-6324
Fiona M CampbellDepartment of Paediatric Diabetes, Leeds Children's Hospital, Leeds, UK.
Katharine DraxlbauerUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Daniela ElleriDepartment of Diabetes, Royal Hospital for Sick Children, Edinburgh, UK.
Mark L EvansMetabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK.ORCID 0000-0001-8122-8987
Elke Fröhlich-ReitererDepartment of Pediatric and Adolescent Medicine, Medical University of Graz, Graz, Austria.
Atrayee GhatakDepartment of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
Sabine E HoferDepartment of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria.
Thomas M KapellenHospital for Children and Adolescents, Leipzig University, Leipzig, Germany.
Lalantha LeelarathnaDiabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.ORCID 0000-0001-9602-1962
Julia K MaderDivision of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.ORCID 0000-0001-7854-4233
Womba M MubitaInstitute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
Parth NarendranUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Tina PoettlerDivision of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Birgit Rami-MerharDepartment of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
Martin TauschmannDepartment of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
Tabitha RandellDepartment of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Hood ThabitDiabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.ORCID 0000-0001-6076-6997
Ajay ThankamonyDepartment of Paediatrics, University of Cambridge, Cambridge, UK.
Nicola TrevelyanDepartment of Paediatric Endocrinology and Diabetes, Southampton Children's Hospital, Southampton General Hospital, Southampton, UK.
Roman HovorkaMetabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK.ORCID 0000-0003-2901-461X

Funding

24/7 closed-loop in older subjects with type 1 diabetesDP3DK112176 · NIDDK · UNIVERSITY OF CAMBRIDGE · PI HOVORKA, ROMAN · 2016 to 2016
$1.9M
NIDDK NIH HHS DP3 DK112176Wellcome Trust
6 · The paper itself

Abstract

objectiveMany 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.

methodsWe retrospectively analyzed data from closed-loop studies involving young children (1-7 years,

resultsEight 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;

conclusionsUse 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.

Indexed as

AlgorithmsBlood GlucoseDiabetes Mellitus, Type 1HypoglycemiaHypoglycemic AgentsInsulinInsulin Infusion SystemsAdolescentAdultAgedChildChild, PreschoolFemaleHumansInfantMaleBlood GlucoseHypoglycemic AgentsInsulinartificial pancreasautomated insulin deliveryclosed-loophypoglycemiapersonalized medicinetype 1 diabetes

Identifiers

PMID36475908
PMCPMC11307210

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.