Cargando…

Blood Glucose Control in Type 1 Diabetes With a Bihormonal Bionic Endocrine Pancreas

OBJECTIVE: To test whether safe and effective glycemic control could be achieved in type 1 diabetes using a bihormonal bionic endocrine pancreas driven by a continuous glucose monitor in experiments lasting more than two days and including six high-carbohydrate meals and exercise as challenges to gl...

Descripción completa

Detalles Bibliográficos
Autores principales: Russell, Steven J., El-Khatib, Firas H., Nathan, David M., Magyar, Kendra L., Jiang, John, Damiano, Edward R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3476884/
https://www.ncbi.nlm.nih.gov/pubmed/22923666
http://dx.doi.org/10.2337/dc12-0071
_version_ 1782247122609897472
author Russell, Steven J.
El-Khatib, Firas H.
Nathan, David M.
Magyar, Kendra L.
Jiang, John
Damiano, Edward R.
author_facet Russell, Steven J.
El-Khatib, Firas H.
Nathan, David M.
Magyar, Kendra L.
Jiang, John
Damiano, Edward R.
author_sort Russell, Steven J.
collection PubMed
description OBJECTIVE: To test whether safe and effective glycemic control could be achieved in type 1 diabetes using a bihormonal bionic endocrine pancreas driven by a continuous glucose monitor in experiments lasting more than two days and including six high-carbohydrate meals and exercise as challenges to glycemic control. RESEARCH DESIGN AND METHODS: Six subjects with type 1 diabetes and no endogenous insulin secretion participated in two 51-h experiments. Blood glucose was managed with a bionic endocrine pancreas controlling subcutaneous delivery of insulin and glucagon with insulin pumps. A partial meal-priming bolus of insulin (0.035 units/kg/meal, then 0.05 units/kg/meal in repeat experiments) was administered at the beginning of each meal (on average 78 ± 12 g of carbohydrates per meal were consumed). Plasma glucose (PG) control was evaluated with a reference quality measurement on venous blood every 15 min. RESULTS: The overall mean PG was 158 mg/dL, with 68% of PG values in the range of 70–180 mg/dL. There were no significant differences in mean PG between larger and smaller meal-priming bolus experiments. Hypoglycemia (PG <70 mg/dL) was rare, with eight incidents during 576 h of closed-loop control (0.7% of total time). During 192 h of nighttime control, mean PG was 123 mg/dL, with 93% of PG values in the range of 70–180 mg/dL and only one episode of mild hypoglycemia (minimum PG 62 mg/dL). CONCLUSIONS: A bihormonal bionic endocrine pancreas achieved excellent glycemic control with minimal hypoglycemia over the course of two days of continuous use despite high-carbohydrate meals and exercise. A trial testing a wearable version of the system under free-living conditions is justified.
format Online
Article
Text
id pubmed-3476884
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher American Diabetes Association
record_format MEDLINE/PubMed
spelling pubmed-34768842013-11-01 Blood Glucose Control in Type 1 Diabetes With a Bihormonal Bionic Endocrine Pancreas Russell, Steven J. El-Khatib, Firas H. Nathan, David M. Magyar, Kendra L. Jiang, John Damiano, Edward R. Diabetes Care Original Research OBJECTIVE: To test whether safe and effective glycemic control could be achieved in type 1 diabetes using a bihormonal bionic endocrine pancreas driven by a continuous glucose monitor in experiments lasting more than two days and including six high-carbohydrate meals and exercise as challenges to glycemic control. RESEARCH DESIGN AND METHODS: Six subjects with type 1 diabetes and no endogenous insulin secretion participated in two 51-h experiments. Blood glucose was managed with a bionic endocrine pancreas controlling subcutaneous delivery of insulin and glucagon with insulin pumps. A partial meal-priming bolus of insulin (0.035 units/kg/meal, then 0.05 units/kg/meal in repeat experiments) was administered at the beginning of each meal (on average 78 ± 12 g of carbohydrates per meal were consumed). Plasma glucose (PG) control was evaluated with a reference quality measurement on venous blood every 15 min. RESULTS: The overall mean PG was 158 mg/dL, with 68% of PG values in the range of 70–180 mg/dL. There were no significant differences in mean PG between larger and smaller meal-priming bolus experiments. Hypoglycemia (PG <70 mg/dL) was rare, with eight incidents during 576 h of closed-loop control (0.7% of total time). During 192 h of nighttime control, mean PG was 123 mg/dL, with 93% of PG values in the range of 70–180 mg/dL and only one episode of mild hypoglycemia (minimum PG 62 mg/dL). CONCLUSIONS: A bihormonal bionic endocrine pancreas achieved excellent glycemic control with minimal hypoglycemia over the course of two days of continuous use despite high-carbohydrate meals and exercise. A trial testing a wearable version of the system under free-living conditions is justified. American Diabetes Association 2012-11 2012-10-13 /pmc/articles/PMC3476884/ /pubmed/22923666 http://dx.doi.org/10.2337/dc12-0071 Text en © 2012 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Original Research
Russell, Steven J.
El-Khatib, Firas H.
Nathan, David M.
Magyar, Kendra L.
Jiang, John
Damiano, Edward R.
Blood Glucose Control in Type 1 Diabetes With a Bihormonal Bionic Endocrine Pancreas
title Blood Glucose Control in Type 1 Diabetes With a Bihormonal Bionic Endocrine Pancreas
title_full Blood Glucose Control in Type 1 Diabetes With a Bihormonal Bionic Endocrine Pancreas
title_fullStr Blood Glucose Control in Type 1 Diabetes With a Bihormonal Bionic Endocrine Pancreas
title_full_unstemmed Blood Glucose Control in Type 1 Diabetes With a Bihormonal Bionic Endocrine Pancreas
title_short Blood Glucose Control in Type 1 Diabetes With a Bihormonal Bionic Endocrine Pancreas
title_sort blood glucose control in type 1 diabetes with a bihormonal bionic endocrine pancreas
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3476884/
https://www.ncbi.nlm.nih.gov/pubmed/22923666
http://dx.doi.org/10.2337/dc12-0071
work_keys_str_mv AT russellstevenj bloodglucosecontrolintype1diabeteswithabihormonalbionicendocrinepancreas
AT elkhatibfirash bloodglucosecontrolintype1diabeteswithabihormonalbionicendocrinepancreas
AT nathandavidm bloodglucosecontrolintype1diabeteswithabihormonalbionicendocrinepancreas
AT magyarkendral bloodglucosecontrolintype1diabeteswithabihormonalbionicendocrinepancreas
AT jiangjohn bloodglucosecontrolintype1diabeteswithabihormonalbionicendocrinepancreas
AT damianoedwardr bloodglucosecontrolintype1diabeteswithabihormonalbionicendocrinepancreas