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Reduction in Duration of Hypoglycemia by Automatic Suspension of Insulin Delivery: The In-Clinic ASPIRE Study
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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“when comparing the safety and efficacy of overnight closed-loop delivery of insulin with conventional insulin-pump therapy in adults with type 1 diabetes, closed-loop delivery improved overnight control of glycaemia and reduced the risk of nocturnal hypoglycaemia.98,99”
From Type 1 diabetes (2014) · cites this paper as [98]
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Metadata
- 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
- Venue
- Diabetes Technology & Therapeutics
- Publisher
- SAGE Publications
- Published
- 2012-03
- Volume
- 14
- Issue
- 3
- Pages
- 205-209
- ISSN
- 1520-9156 (ISSN-L)
- 1557-8593
- 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
- 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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