학술논문
Assessment of the Impact of Subcutaneous Catheter Change on Glucose Control in Patients with Type 1 Diabetes Treated by Insulin Pump in Open- and Closed-Loop Modes.
Document Type
Academic Journal
Author
Julla JB; Department of Endocrinology and Diabetes, Centre Universitaire du diabète et de ses complications, APHP, Hôpital Lariboisière, Université Paris-Cité, Paris, Île-de-France, France.; Institut Necker Enfants Malades, INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory, Paris, France.; Jacquemier P; Institut Necker Enfants Malades, INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory, Paris, France.; Centre Explor, ALHIST-Air Liquide Healthcare, Bagneux, France.; Bonnemaison E; Pediapole, Clinique Saint Jean, Saint Jean de vedas, Montpellier Métropole, France.; Fagherazzi G; Luxembourg Institute of Health, Deep Digital Phenotyping Research Unit, Department of Precision Health, Strassen, Luxembourg.; Hanaire H; Department of Diabetology, Rangueil, Toulouse University Hospital, Toulouse, France.; Bellicar Schaepelynck P; Department of Diabetology, Sainte Marguerite Hospital, Marseille, France.; Mihaileanu M; Air Liquide Healthcare, Vitalaire France, Gentilly, France.; Renard E; Department of Endocrinology and Diabetes, Montpellier University Hospital, Montpellier, France and Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.; Reznik Y; Department of Endocrinology and Diabetes, CHU Côte de Nacre, Caen Cedex, France and Unicaen, Caen Cedex, France.; Riveline JP; Department of Endocrinology and Diabetes, Centre Universitaire du diabète et de ses complications, APHP, Hôpital Lariboisière, Université Paris-Cité, Paris, Île-de-France, France.; Institut Necker Enfants Malades, INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory, Paris, France.
Source
Publisher: Mary Ann Liebert, Inc Country of Publication: United States NLM ID: 100889084 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-8593 (Electronic) Linking ISSN: 15209156 NLM ISO Abbreviation: Diabetes Technol Ther Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: Most continuous subcutaneous insulin infusion (CSII) catheters (KT) are changed every 3 days. This study aims at evaluating whether KT changes impact glucose control while under open-loop (OL) or automated insulin delivery (AID) modes. Methods: We included patients with type 1 diabetes who used Tandem t:slim x2 insulin pump and Dexcom G6 glucose sensor for 20 days in OL, then as AID. CSII and sensor glucose data in OL and for the past 20 days of 3-month AID were retrospectively analyzed. The percentage of time spent with sensor glucose above 180 mg/dL (%TAR180) was compared between the calendar day of KT change (D0), the next day (D1), and 2 days later (D2). Values were adjusted for age, gender, body mass index (BMI), hemoglobin A1c (HbA1c) at inclusion, and %TAR180 for the 2 h before KT change. Results: A total of 1636 KT changes were analyzed in 134 patients: 72 women (54%), age: 35.6 ± 15.7 years, BMI: 25.2 ± 4.7 kg/m 2 , and HbA1c: 7.5 ± 0.8%. %TAR180 in the 2 h before the KT change was 51.3 ± 37.0% in OL and 33.2 ± 30.0% in AID mode. In OL, significant absolute increases of %TAR180 at D0 versus D1 (+6.9%; P < 0.0001) or versus D2 (+6.8%; P < 0.0001) were observed. In AID, significant absolute increases of %TA180R at D0 versus D1 (+4.8%; P < 0.0001) or versus D2 (+4.2%; P < 0.0001) were also observed. Conclusion: This study shows an increase in time spent in hyperglycemia on the day of the KT change both in OL and AID modes. This additional information should be taken into account to improve current AID algorithms. ClinicalTrials.gov: NCT04939766.