دورية أكاديمية
Adjusting Therapy Profiles When Switching to Ultra-Rapid Lispro in an Advanced Hybrid Closed-Loop System: An in Silico Study.
| العنوان: | Adjusting Therapy Profiles When Switching to Ultra-Rapid Lispro in an Advanced Hybrid Closed-Loop System: An in Silico Study. |
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| المؤلفون: | Colmegna P; Center for Diabetes Technology, University of Virginia, Charlottesville, VA, USA., Diaz C JL; Center for Diabetes Technology, University of Virginia, Charlottesville, VA, USA., Garcia-Tirado J; Center for Diabetes Technology, University of Virginia, Charlottesville, VA, USA., DeBoer MD; Center for Diabetes Technology, University of Virginia, Charlottesville, VA, USA., Breton MD; Center for Diabetes Technology, University of Virginia, Charlottesville, VA, USA. |
| المصدر: | Journal of diabetes science and technology [J Diabetes Sci Technol] 2024 May; Vol. 18 (3), pp. 676-685. Date of Electronic Publication: 2022 Nov 24. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Sage Country of Publication: United States NLM ID: 101306166 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1932-2968 (Electronic) Linking ISSN: 19322968 NLM ISO Abbreviation: J Diabetes Sci Technol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2014- : Thousand Oaks, CA : Sage Original Publication: Foster City, CA : Diabetes Technology Society |
| مواضيع طبية MeSH: | Insulin Lispro*/administration & dosage , Insulin Lispro*/pharmacokinetics , Hypoglycemic Agents*/administration & dosage , Hypoglycemic Agents*/pharmacokinetics , Computer Simulation* , Blood Glucose*/analysis , Blood Glucose*/drug effects , Insulin Infusion Systems*, Humans ; Algorithms ; Diabetes Mellitus, Type 1/drug therapy ; Diabetes Mellitus, Type 1/blood ; Insulin/administration & dosage ; Insulin/pharmacokinetics |
| مستخلص: | Background: It has been shown that insulin acceleration by itself might not be sufficient to see clear improvements in glycemic metrics, and insulin therapy may need to be adjusted to fully leverage the extra safety margin provided by faster pharmacokinetic (PK) and pharmacodynamic (PD) profiles. The objective of this work is to explore how to perform such adjustments on a commercially available automated insulin delivery (AID) system. Methods: Ultra-rapid lispro (URLi) is modeled within the UVA/Padova simulation platform using data from previously published clamp studies. The Control-IQ AID algorithm is selected as it leverages carbohydrate-to-insulin ratio (CR in g/U), correction factor (CF in mg/dL/U), and basal rate (BR in U/h) daily profiles that are fully customizable. An experiment roadmap is proposed to understand how to safely modify these profiles when switching from lispro to URLi. Results: Simulations show that a 7% decrease in CR (approximately an 8% increase in prandial insulin) and a 7.5% increase in BR lead to cumulative improvements in glucose control with URLi. Comparing with baseline metrics using lispro, a clinically significant increase in time in the range of 70 to 180 mg/dL (overall: 70.2%-75.2%, P < .001; 6 am-12 am: 62.4%-68.5%, P < .001) and a reduction in time below 70 mg/dL (overall: 1.8%-1.2%, P < .001; 6 am-12 am: 1.8%-1.3%, P < .001) were observed. Conclusion: Properly adjusting therapy parameters allows to fully leverage glucose control benefits provided by faster insulin analogues, opening opportunities to take another step forward into a next generation of more effective AID solutions. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: PC, JD, and JG receive research support and royalties from Dexcom handled by the University of Virginia’s Licensing and Ventures Group. MDD has received research support from Tandem, Dexcom, and Medtronic. MDB consults for Roche Diagnostics, Dexcom, Adocia, and Arecor; receives research support from Dexcom, Tandem, and Novo Nordisk. |
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| معلومات مُعتمدة: | R01 DK129553 United States DK NIDDK NIH HHS |
| فهرسة مساهمة: | Keywords: automated insulin delivery; glucose control; insulin therapy parameters; type 1 diabetes; ultra-rapid insulin analogues |
| المشرفين على المادة: | 0 (Insulin Lispro) 0 (Hypoglycemic Agents) 0 (Blood Glucose) 0 (Insulin) |
| تواريخ الأحداث: | Date Created: 20221125 Date Completed: 20240501 Latest Revision: 20240515 |
| رمز التحديث: | 20240515 |
| مُعرف محوري في PubMed: | PMC11089876 |
| DOI: | 10.1177/19322968221140401 |
| PMID: | 36424765 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1932-2968 |
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| DOI: | 10.1177/19322968221140401 |