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Reduction in Duration of Hypoglycemia by Automatic Suspension of Insulin Delivery: The In-Clinic ASPIRE Study

Garg, Satish, Brazg, Ronald L., Bailey, Timothy S., Buckingham, Bruce A., Slover, Robert H., Klonoff, David C., Shin, John, Welsh, John B., Kaufman, Francine R.·2012·Diabetes Technology & Therapeutics

DOI 10.1089/dia.2011.0292

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Abstract

Background The efficacy of automatic suspension of insulin delivery in induced hypoglycemia among subjects with type 1 diabetes was evaluated. Subjects and methods In this randomized crossover study, subjects used a sensor-augmented insulin pump system with a low glucose suspend (LGS) feature that automatically stops insulin delivery for 2 h following a sensor glucose (SG) value ≤70 mg/dL. Subjects fasted overnight and exercised until their plasma glucose (measured with the YSI 2300 STAT Plus™ glucose and lactate analyzer [YSI Life Sciences, Yellow Springs, OH]) value reached ≤85 mg/dL on different occasions separated by washout periods lasting 3-10 days. Exercise sessions were done with the LGS feature turned on (LGS-On) or with continued insulin delivery regardless of SG value (LGS-Off). The order of LGS-On and LGS-Off sessions was randomly assigned. YSI glucose data were used to compare the duration and severity of hypoglycemia from successful LGS-On and LGS-Off sessions and to estimate the risk of rebound hyperglycemia after pump suspension. Results Fifty subjects attempted 134 sessions, 98 of which were successful. The mean±SD hypoglycemia duration was less during LGS-On than during LGS-Off sessions (138.5±76.68 vs. 170.7±75.91 min, P=0.006). During LGS-On compared with LGS-Off sessions, mean nadir YSI glucose was higher (59.5±5.72 vs. 57.6±5.69 mg/dL, P=0.015), as was mean end-observation YSI glucose (91.4±41.84 vs. 66.2±13.48 mg/dL, P 250 mg/dL. Conclusions Automatic s…

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Authors: Garg, S., Brazg, R. L., Bailey, T. S., Buckingham, B. A., Slover, R. H., Klonoff, D. C., Shin, J., Welsh, J. B., & Kaufman, F. R.
Affiliations: Barbara Davis Center for Childhood Diabetes, Aurora, Colorado.
Rainier Clinical Research Center (US)
AMCR Institute (US)
Stanford Medicine (US)
Mills Peninsula Health Services (US)
Medtronic Inc., Northridge, California.
Corresponding author: Garg, Satish
ORCID: Garg, Satish
Bailey, Timothy S.
Buckingham, Bruce A.
Klonoff, David C.
Shin, John
Welsh, John B.
Kaufman, Francine R.
Venue: Diabetes Technology & Therapeutics
Publisher: SAGE Publications
Published: 2012-03
Volume: 14
Issue: 3
Pages: 205-209
ISSN: 1520-9156 (ISSN-L)
1557-8593
DOI: 10.1089/dia.2011.0292
OpenAlex: W1978849955
Cited by: 138
References: 9
Citations by year: 2026: 1 · 2025: 2 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 7 · 2020: 6 · 2019: 10 · 2018: 8 · 2017: 11 · 2016: 16 · 2015: 17 · 2014: 16 · 2013: 21 · 2012: 10
FWCI: 16.43
Type: journal article
Language: en
Open access: closed
Licence: www.liebertpub.com/nv/resources-tools/text-and-data-mining-policy/121/ (tdm)
Locations: Diabetes Technology & Therapeutics (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords: type 1 diabetes, hypoglycemia, low glucose suspend, sensor-augmented pump, exercise-induced hypoglycemia, rebound hyperglycemia, hypoglycemia duration, hypoglycemia severity, continuous glucose monitoring
MeSH terms: Adolescent, Adult, Blood Glucose, Diabetes Mellitus, Type 1, Female, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Male, Middle Aged, Treatment Outcome, Cross-Over Studies, Monitoring, Ambulatory, Young Adult

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Reduction in Duration of Hypoglycemia by Automatic Suspension of Insulin Delivery: The In-Clinic ASPIRE Study

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