PT  - JOURNAL ARTICLE
AU  - Leelarathna, Lalantha
AU  - Dellweg, Sibylle
AU  - Mader, Julia K.
AU  - Allen, Janet M.
AU  - Benesch, Carsten
AU  - Doll, Werner
AU  - Ellmerer, Martin
AU  - Hartnell, Sara
AU  - Heinemann, Lutz
AU  - Kojzar, Harald
AU  - Michalewski, Lucy
AU  - Nodale, Marianna
AU  - Thabit, Hood
AU  - Wilinska, Malgorzata E.
AU  - Pieber, Thomas R.
AU  - Arnolds, Sabine
AU  - Evans, Mark L.
AU  - Hovorka, Roman
TI  - Day and Night Home Closed-Loop Insulin Delivery in Adults With Type 1 Diabetes: Three-Center Randomized Crossover Study
AID  - 10.2337/dc13-2911
DP  - 2014 Jul 01
TA  - Diabetes Care
PG  - 1931--1937
VI  - 37
IP  - 7
4099  - http://care.diabetesjournals.org/content/37/7/1931.short
4100  - http://care.diabetesjournals.org/content/37/7/1931.full
SO  - Diabetes Care2014 Jul 01; 37
AB  - OBJECTIVE To evaluate the feasibility of day and night closed-loop insulin delivery in adults with type 1 diabetes under free-living conditions.RESEARCH DESIGN AND METHODS Seventeen adults with type 1 diabetes on insulin pump therapy (means ± SD age 34 ± 9 years, HbA1c 7.6 ± 0.8%, and duration of diabetes 19 ± 9 years) participated in an open-label multinational three-center crossover study. In a random order, participants underwent two 8-day periods (first day at the clinical research facility followed by 7 days at home) of sensor-augmented insulin pump therapy (SAP) or automated closed-loop insulin delivery. The primary end point was the time when sensor glucose was in target range between 3.9 and 10.0 mmol/L during the 7-day home phase.RESULTS During the home phase, the percentage of time when glucose was in target range was significantly higher during closed-loop compared with SAP (median 75% [interquartile range 61–79] vs. 62% [53–70], P = 0.005). Mean glucose (8.1 vs. 8.8 mmol/L, P = 0.027) and time spent above target (P = 0.013) were lower during closed loop, while time spent below target was comparable (P = 0.339). Increased time in target was observed during both daytime (P = 0.017) and nighttime (P = 0.013).CONCLUSIONS Compared with SAP, 1 week of closed-loop insulin delivery at home reduces mean glucose and increases time in target without increasing the risk of hypoglycemia in adults with relatively well-controlled type 1 diabetes.