Dataset Information

Full closed loop open-source algorithm performance comparison in pigs with diabetes.

ABSTRACT: Understanding how automated insulin delivery (AID) algorithm features impact glucose control under full closed loop delivery represents a critical step toward reducing patient burden by eliminating the need for carbohydrate entries at mealtimes. Here, we use a pig model of diabetes to compare AndroidAPS and Loop open-source AID systems without meal announcements. Overall time-in-range (70-180 mg/dl) for AndroidAPS was 58% ± 5%, while time-in-range for Loop was 35% ± 5%. The effect of the algorithms on time-in-range differed between meals and overnight. During the overnight monitoring period, pigs had an average time-in-range of 90% ± 7% when on AndroidAPS compared to 22% ± 8% on Loop. Time-in-hypoglycemia also differed significantly during the lunch meal, whereby pigs running AndroidAPS spent an average of 1.4% (+0.4/-0.8)% in hypoglycemia compared to 10% (+3/-6)% for those using Loop. As algorithm design for closed loop systems continues to develop, the strategies employed in the OpenAPS algorithm (known as oref1) as implemented in AndroidAPS for unannounced meals may result in a better overall control for full closed loop systems.

SUBMITTER: Lal RA

PROVIDER: S-EPMC8087942 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Full closed loop open-source algorithm performance comparison in pigs with diabetes.

Lal Rayhan A RA Maikawa Caitlin L CL Lewis Dana D Baker Sam W SW Smith Anton A A AAA Roth Gillie A GA Gale Emily C EC Stapleton Lyndsay M LM Mann Joseph L JL Yu Anthony C AC Correa Santiago S Grosskopf Abigail K AK Liong Celine S CS Meis Catherine M CM Chan Doreen D Garner Joseph P JP Maahs David M DM Buckingham Bruce A BA Appel Eric A EA

Clinical and translational medicine 20210401 4

Understanding how automated insulin delivery (AID) algorithm features impact glucose control under full closed loop delivery represents a critical step toward reducing patient burden by eliminating the need for carbohydrate entries at mealtimes. Here, we use a pig model of diabetes to compare AndroidAPS and Loop open-source AID systems without meal announcements. Overall time-in-range (70-180 mg/dl) for AndroidAPS was 58% ± 5%, while time-in-range for Loop was 35% ± 5%. The effect of the algorit ...[more]

PMID: 33931977

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Project description:ObjectiveAs an emerging technology, Android-based open-source closed-loop system also called Android Artificial Pancreas System (AAPS), has been increasingly validated by evidence for its effectiveness in improving glycaemic outcomes, positioning it as a crucial option for managing type 1 diabetes (T1D). However, there are still only a few studies examining the experiences of using AAPS, and relevant qualitative studies have not been conducted in Asia so far. This study aimed to explore the experiences and opinions of adult patients with T1D on the AAPS.DesignSemi-structured interviews and the Insulin Dosing Systems: Perceptions, Ideas, Reflections and Expectations questionnaires were conducted among patients. The questionnaire was scored on a 100-point scale. Thematic analysis was adopted to analyse the transcribed text. Recruitment of interviewees would be halted when no new themes emerged. The scores of the questionnaire on AAPS satisfaction were calculated, and the Mann-Whitney U test was used to compare the results of different sections of the questionnaire.SettingGuangdong Province in China.ParticipantsThis study recruited patients with T1D from the Guangdong T1D translational medicine study and the 'Tang Tang Quan' T1D online community in China, who participated in a clinical trial on the efficacy and safety of AAPS.ResultsThe study interviewed 20 adults with T1D aged 32±9.94 years. The T1D duration was 10.93±6.26 years and the glycated haemoglobin was 7.38±0.53%. Five main themes were identified: (1) expectations and feedback on AAPS; (2) impact on quality of life; (3) impact on blood glucose management; (4) user experiences; (5) suggestions for AAPS. The average score of AAPS satisfaction was 73.69 (65.94, 85.94). Mann-Whitney U test suggested that the satisfaction derived from glucose management with AAPS surpassed the satisfaction attributed to the enhancement of their overall quality of life (p<0.05).ConclusionsAdults with T1D had generally positive experiences with AAPS. The future focus of AAPS research and development should be on optimising glycaemic management, improving device experience and reducing costs.Trial registration numberNCT05726461; Pre-results.

Project description:ObjectiveTo assess the efficacy and safety of a dual-hormone (DH [insulin and glucagon]) closed-loop system compared to a single-hormone (SH [insulin only]) closed-loop system in adolescents with type 1 diabetes.MethodsThis was a 26-hour, two-period, randomized, crossover, inpatient study involving 11 adolescents with type 1 diabetes (nine males [82%], mean ± SD age 14.8 ± 1.4 years, diabetes duration 5.7 ± 2.3 years). Except for the treatment configuration of the DiaCon Artificial Pancreas: DH or SH, experimental visits were identical consisting of: an overnight stay (10:00 pm until 7:30 am), several meals/snacks, and a 45-minute bout of moderate intensity continuous exercise. The primary endpoint was percentage of time spent with sensor glucose values below range (TBR [<3.9 mmol/L]) during closed-loop control over the 26-h period (5:00 pm, day 1 to 7:00 pm, day 2).ResultsOverall, there were no differences between DH and SH for the following glycemic outcomes (median [IQR]): TBR 1.6 [0.0, 2.4] vs. 1.28 [0.16, 3.19]%, p=1.00; time in range (TIR [3.9-10.0 mmol/L]) 68.4 [48.7, 76.8] vs. 75.7 [69.8, 87.1]%, p=0.08; and time above range (TAR [>10.0 mmol/L]) 28.1 [18.1, 49.8] vs. 23.3 [12.3, 27.2]%, p=0.10. Mean ( ± SD) glucose was higher during DH than SH (8.7 ( ± 3.2) vs. 8.1 ( ± 3.0) mmol/L, p<0.001) but coefficient of variation was similar (34.8 ( ± 6.8) vs. 37.3 ( ± 8.6)%, p=0.20). The average amount of rescue carbohydrates was similar between DH and SH (6.8 ( ± 12.3) vs. 9.5 ( ± 15.4) grams/participant/visit, p=0.78). Overnight, TIR was higher, TAR was lower during the SH visit compared to DH. During and after exercise (4:30 pm until 7 pm) the SH configuration produced higher TIR, but similar TAR and TBR compared to the DH configuration.ConclusionsDH and SH performed similarly in adolescents with type 1 diabetes during a 26-hour inpatient monitoring period involving several metabolic challenges including feeding and exercise. However, during the night and around exercise, the SH configuration outperformed DH.

Dataset Information

Full closed loop open-source algorithm performance comparison in pigs with diabetes.

Publications

Full closed loop open-source algorithm performance comparison in pigs with diabetes.

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