Evaluation of a Clinical Tool to Test and Adjust the Programmed Overnight Basal Profiles for Insulin Pump Therapy: A Pilot Study

Abstract Objective Clinical protocols for basal rate testing and adjustment are needed for effective insulin pump therapy. We evaluated the effects of a continuous glucose monitoring (CGM)-based semiautomated basal algorithm on glycemia. Methods We developed and piloted a basal rate analyzer that in...

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Veröffentlicht in:	Canadian journal of diabetes 2015-10, Vol.39 (5), p.364-372
Hauptverfasser:	Orszag, Andrej, MD, Falappa, C. Marcelo, MD, Lovblom, Leif E., MSc, Partridge, Helen, MRCP, Tschirhart, Holly, BScN, Boulet, Genevieve, MD, Picton, Peter, MASc, PEng, Cafazzo, Joseph A., PhD, PEng, Perkins, Bruce A., MD, MPH, FRCP(C)
Format:	Artikel
Sprache:	eng
Schlagworte:	Adult basal insulin assessment Blood Glucose continuous glucose monitoring continuous subcutaneous insulin infusion diabète de type 1 Endocrinology & Metabolism estimation de l’insuline basale Female Humans Insulin Infusion Systems insulin pump therapy Male Middle Aged Monitoring, Physiologic - instrumentation Monitoring, Physiologic - methods Other perfusion sous-cutanée continue d’insuline Pilot Projects surveillance de la glycémie en continu thérapie par pompe à insuline type 1 diabetes
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Zusammenfassung:	Abstract Objective Clinical protocols for basal rate testing and adjustment are needed for effective insulin pump therapy. We evaluated the effects of a continuous glucose monitoring (CGM)-based semiautomated basal algorithm on glycemia. Methods We developed and piloted a basal rate analyzer that interpreted CGM data from overnight fasts and recommended dose changes for subsequent nights. Subjects uploaded data online using sensor-augmented pumps for evaluation by the analyzer after each of 5 overnight fasts conducted over 2 to 8 weeks. It was designed to be conservative and iterative, making changes that did not exceed 10% at each iteration. The standard deviation and interquartile range of CGM values from midnight to 7 am (SD12-7am and IQR12-7am ) over 3 baseline and 3 postintervention nights, hypoglycemia incidence (CGM values
ISSN:	1499-2671 2352-3840
DOI:	10.1016/j.jcjd.2015.01.005