Suspended insulin infusion during overnight closed-loop glucose control in children and adolescents with Type 1 diabetes
Version of Record online: 12 JAN 2010
© 2010 The Authors. Journal compilation © 2010 Diabetes UK
Volume 27, Issue 4, pages 480–484, April 2010
How to Cite
Elleri, D., Allen, J. M., Nodale, M., Wilinska, M. E., Acerini, C. L., Dunger, D. B. and Hovorka, R. (2010), Suspended insulin infusion during overnight closed-loop glucose control in children and adolescents with Type 1 diabetes. Diabetic Medicine, 27: 480–484. doi: 10.1111/j.1464-5491.2010.02964.x
- Issue online: 7 APR 2010
- Version of Record online: 12 JAN 2010
- Accepted 4 January 2010
- closed-loop systems;
- interruption of insulin infusion;
- overnight hypoglycaemia
Diabet. Med. 27, 480–484 (2010)
Aims We assessed an extended interruption of subcutaneous insulin delivery during overnight closed-loop glucose control in children and adolescents with Type 1 diabetes (T1D).
Methods In seven young subjects with T1D [age 14.2 ± 2.1 years, diabetes duration 6.9 ± 4.0 years, glycated haemoglobin (HbA1c) 8.0 ± 1.5%, body mass index (BMI) 21.4 ± 4.0 kg/m2, total daily insulin dose 0.9 ± 0.2 units/kg/day; mean ± sd) participating in overnight closed-loop glucose control studies, insulin delivery was interrupted for at least 90 min on the basis of predicted hypoglycaemia, low prevailing glucose levels or a too-steep decline in glucose levels.
Results Insulin delivery was interrupted for 165 (105, 210) min [median, interquartile range (IQR)]. Plasma glucose was 6.2 ± 3.2 mmol/l at the time of interruption and 5.5 ± 2.0 mmol/l 105 min later (P = 0.15, paired t-test). Plasma glucose declined during the first hour of the interruption at a rate of 0.02 ± 0.03 mmol/l per min and reached a nadir of 5.2 ± 2.7 mmol/l; 105 min after the interruption, plasma glucose was increasing at a rate of 0.01 ± 0.03 mmol/l per min. When insulin delivery restarted, plasma glucose was 6.4 ± 2.2 mmol/l and peaked at 7.9 ± 2.1 mmol/l in 60 min (P = 0.01). Physiological levels of plasma insulin were measured throughout with a nadir of 119 ± 78 pmol/l.
Conclusions A prolonged interruption of insulin delivery during overnight closed-loop glucose control to prevent hypoglycaemia was not associated with an increased risk of hyperglycaemia in young people with T1D.