Predictors of Hypoglycemia in the ASPIRE In-Home Study and Effects of Automatic Suspension of Insulin Delivery
Background: Hypoglycemia varies between patients with type 1 diabetes and is the main obstacle to therapy intensification. We investigated known and potential risk factors for hypoglycemia in subjects with type 1 diabetes. Method: In the ASPIRE In-Home study (NCT01497938), a randomized trial of the...
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| Veröffentlicht in: | Journal of diabetes science and technology 2015-05, Vol.9 (5), p.1016-1020 |
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| creator | Weiss, Ram Garg, Satish K. Bergenstal, Richard M. Klonoff, David C. Bode, Bruce W. Bailey, Timothy S. Thrasher, James Schwartz, Frank Welsh, John B. Kaufman, Francine R. Brazg, R. Casaubon, L. Horowitz, B. Liljenquist, D. Odugbesan, O. Bhargava, A. Goland, R. Weinstock, R. |
| description | Background:
Hypoglycemia varies between patients with type 1 diabetes and is the main obstacle to therapy intensification. We investigated known and potential risk factors for hypoglycemia in subjects with type 1 diabetes.
Method:
In the ASPIRE In-Home study (NCT01497938), a randomized trial of the threshold suspend (TS) feature of sensor-augmented insulin pump (SAP) therapy, subjects’ propensity to nocturnal hypoglycemia (NH) was established in a 2-week run-in phase and assessed in a 3-month study phase via continuous glucose monitoring. Categorical variables were tested for association with NH rates in both phases.
Results:
Elevated rates of NH were significantly associated with baseline A1C ≤7%, with bolus insulin deliveries unassisted by the bolus estimation calculator, and with assignment to the control group during the study phase.
Conclusions:
Routine use of the TS feature and the bolus estimation calculator are strategies that may reduce the risk of NH. |
| doi_str_mv | 10.1177/1932296815586014 |
| format | Article |
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Hypoglycemia varies between patients with type 1 diabetes and is the main obstacle to therapy intensification. We investigated known and potential risk factors for hypoglycemia in subjects with type 1 diabetes.
Method:
In the ASPIRE In-Home study (NCT01497938), a randomized trial of the threshold suspend (TS) feature of sensor-augmented insulin pump (SAP) therapy, subjects’ propensity to nocturnal hypoglycemia (NH) was established in a 2-week run-in phase and assessed in a 3-month study phase via continuous glucose monitoring. Categorical variables were tested for association with NH rates in both phases.
Results:
Elevated rates of NH were significantly associated with baseline A1C ≤7%, with bolus insulin deliveries unassisted by the bolus estimation calculator, and with assignment to the control group during the study phase.
Conclusions:
Routine use of the TS feature and the bolus estimation calculator are strategies that may reduce the risk of NH.</description><identifier>ISSN: 1932-2968</identifier><identifier>EISSN: 1932-2968</identifier><identifier>EISSN: 1932-3107</identifier><identifier>DOI: 10.1177/1932296815586014</identifier><identifier>PMID: 25986629</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Blood Glucose - analysis ; Blood Glucose Self-Monitoring ; Diabetes Mellitus, Type 1 - blood ; Diabetes Mellitus, Type 1 - drug therapy ; Female ; Humans ; Hypoglycemia - blood ; Hypoglycemia - chemically induced ; Hypoglycemic Agents - administration & dosage ; Hypoglycemic Agents - adverse effects ; Hypoglycemic Agents - therapeutic use ; Insulin - administration & dosage ; Insulin - adverse effects ; Insulin - therapeutic use ; Insulin Infusion Systems ; Male ; Original</subject><ispartof>Journal of diabetes science and technology, 2015-05, Vol.9 (5), p.1016-1020</ispartof><rights>2015 Diabetes Technology Society</rights><rights>2015 Diabetes Technology Society.</rights><rights>2015 Diabetes Technology Society 2015 Diabetes Technology Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3494-109790289987c9a3cb96b12aea747444607f0bbf1eb1a3728df2f94f5e35f3ee3</citedby><cites>FETCH-LOGICAL-c3494-109790289987c9a3cb96b12aea747444607f0bbf1eb1a3728df2f94f5e35f3ee3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4667346/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4667346/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,21798,27901,27902,43597,43598,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25986629$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Weiss, Ram</creatorcontrib><creatorcontrib>Garg, Satish K.</creatorcontrib><creatorcontrib>Bergenstal, Richard M.</creatorcontrib><creatorcontrib>Klonoff, David C.</creatorcontrib><creatorcontrib>Bode, Bruce W.</creatorcontrib><creatorcontrib>Bailey, Timothy S.</creatorcontrib><creatorcontrib>Thrasher, James</creatorcontrib><creatorcontrib>Schwartz, Frank</creatorcontrib><creatorcontrib>Welsh, John B.</creatorcontrib><creatorcontrib>Kaufman, Francine R.</creatorcontrib><creatorcontrib>Brazg, R.</creatorcontrib><creatorcontrib>Casaubon, L.</creatorcontrib><creatorcontrib>Horowitz, B.</creatorcontrib><creatorcontrib>Liljenquist, D.</creatorcontrib><creatorcontrib>Odugbesan, O.</creatorcontrib><creatorcontrib>Bhargava, A.</creatorcontrib><creatorcontrib>Goland, R.</creatorcontrib><creatorcontrib>Weinstock, R.</creatorcontrib><creatorcontrib>ASPIRE In-Home Study Group</creatorcontrib><title>Predictors of Hypoglycemia in the ASPIRE In-Home Study and Effects of Automatic Suspension of Insulin Delivery</title><title>Journal of diabetes science and technology</title><addtitle>J Diabetes Sci Technol</addtitle><description>Background:
Hypoglycemia varies between patients with type 1 diabetes and is the main obstacle to therapy intensification. We investigated known and potential risk factors for hypoglycemia in subjects with type 1 diabetes.
Method:
In the ASPIRE In-Home study (NCT01497938), a randomized trial of the threshold suspend (TS) feature of sensor-augmented insulin pump (SAP) therapy, subjects’ propensity to nocturnal hypoglycemia (NH) was established in a 2-week run-in phase and assessed in a 3-month study phase via continuous glucose monitoring. Categorical variables were tested for association with NH rates in both phases.
Results:
Elevated rates of NH were significantly associated with baseline A1C ≤7%, with bolus insulin deliveries unassisted by the bolus estimation calculator, and with assignment to the control group during the study phase.
Conclusions:
Routine use of the TS feature and the bolus estimation calculator are strategies that may reduce the risk of NH.</description><subject>Blood Glucose - analysis</subject><subject>Blood Glucose Self-Monitoring</subject><subject>Diabetes Mellitus, Type 1 - blood</subject><subject>Diabetes Mellitus, Type 1 - drug therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Hypoglycemia - blood</subject><subject>Hypoglycemia - chemically induced</subject><subject>Hypoglycemic Agents - administration & dosage</subject><subject>Hypoglycemic Agents - adverse effects</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Insulin - administration & dosage</subject><subject>Insulin - adverse effects</subject><subject>Insulin - therapeutic use</subject><subject>Insulin Infusion Systems</subject><subject>Male</subject><subject>Original</subject><issn>1932-2968</issn><issn>1932-2968</issn><issn>1932-3107</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUFv3CAUhFHVqknT3nOKOPbiBAwGc4m0SrbZlSI16rZnhPFjQ2TDBuxI_vf1dtMoqdQTaN7MB3qD0Ckl55RKeUEVK0slalpVtSCUv0PHe6nYa-9f3Y_Qp5wfCKl4LeVHdFRWqhaiVMco3CVovR1iyjg6vJp2cdtNFnpvsA94uAe82NytfyzxOhSr2APeDGM7YRNavHQO7PAntxiH2JvBW7wZ8w5C9jHs9XXIYzdzrqHzT5Cmz-iDM12GL8_nCfr1bfnzalXcfr9ZXy1uC8u44gUlSipS1krV0irDbKNEQ0sDRnLJORdEOtI0jkJDDZNl3brSKe4qYJVjAOwEXR64u7HpobUQhmQ6vUu-N2nS0Xj9dhL8vd7GJ82FkIyLGfD1GZDi4wh50L3PFrrOBIhj1lQSxZTgTM5WcrDaFHNO4F6eoUTva9L_1jRHzl5_7yXwt5fZUBwM2WxBP8QxhXld_wf-BoyTmy0</recordid><startdate>20150518</startdate><enddate>20150518</enddate><creator>Weiss, Ram</creator><creator>Garg, Satish K.</creator><creator>Bergenstal, Richard M.</creator><creator>Klonoff, David C.</creator><creator>Bode, Bruce W.</creator><creator>Bailey, Timothy S.</creator><creator>Thrasher, James</creator><creator>Schwartz, Frank</creator><creator>Welsh, John B.</creator><creator>Kaufman, Francine R.</creator><creator>Brazg, R.</creator><creator>Casaubon, L.</creator><creator>Horowitz, B.</creator><creator>Liljenquist, D.</creator><creator>Odugbesan, O.</creator><creator>Bhargava, A.</creator><creator>Goland, R.</creator><creator>Weinstock, R.</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20150518</creationdate><title>Predictors of Hypoglycemia in the ASPIRE In-Home Study and Effects of Automatic Suspension of Insulin Delivery</title><author>Weiss, Ram ; Garg, Satish K. ; Bergenstal, Richard M. ; Klonoff, David C. ; Bode, Bruce W. ; Bailey, Timothy S. ; Thrasher, James ; Schwartz, Frank ; Welsh, John B. ; Kaufman, Francine R. ; Brazg, R. ; Casaubon, L. ; Horowitz, B. ; Liljenquist, D. ; Odugbesan, O. ; Bhargava, A. ; Goland, R. ; Weinstock, R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3494-109790289987c9a3cb96b12aea747444607f0bbf1eb1a3728df2f94f5e35f3ee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Blood Glucose - analysis</topic><topic>Blood Glucose Self-Monitoring</topic><topic>Diabetes Mellitus, Type 1 - blood</topic><topic>Diabetes Mellitus, Type 1 - drug therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Hypoglycemia - blood</topic><topic>Hypoglycemia - chemically induced</topic><topic>Hypoglycemic Agents - administration & dosage</topic><topic>Hypoglycemic Agents - adverse effects</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Insulin - administration & dosage</topic><topic>Insulin - adverse effects</topic><topic>Insulin - therapeutic use</topic><topic>Insulin Infusion Systems</topic><topic>Male</topic><topic>Original</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Weiss, Ram</creatorcontrib><creatorcontrib>Garg, Satish K.</creatorcontrib><creatorcontrib>Bergenstal, Richard M.</creatorcontrib><creatorcontrib>Klonoff, David C.</creatorcontrib><creatorcontrib>Bode, Bruce W.</creatorcontrib><creatorcontrib>Bailey, Timothy S.</creatorcontrib><creatorcontrib>Thrasher, James</creatorcontrib><creatorcontrib>Schwartz, Frank</creatorcontrib><creatorcontrib>Welsh, John B.</creatorcontrib><creatorcontrib>Kaufman, Francine R.</creatorcontrib><creatorcontrib>Brazg, R.</creatorcontrib><creatorcontrib>Casaubon, L.</creatorcontrib><creatorcontrib>Horowitz, B.</creatorcontrib><creatorcontrib>Liljenquist, D.</creatorcontrib><creatorcontrib>Odugbesan, O.</creatorcontrib><creatorcontrib>Bhargava, A.</creatorcontrib><creatorcontrib>Goland, R.</creatorcontrib><creatorcontrib>Weinstock, R.</creatorcontrib><creatorcontrib>ASPIRE In-Home Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of diabetes science and technology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Weiss, Ram</au><au>Garg, Satish K.</au><au>Bergenstal, Richard M.</au><au>Klonoff, David C.</au><au>Bode, Bruce W.</au><au>Bailey, Timothy S.</au><au>Thrasher, James</au><au>Schwartz, Frank</au><au>Welsh, John B.</au><au>Kaufman, Francine R.</au><au>Brazg, R.</au><au>Casaubon, L.</au><au>Horowitz, B.</au><au>Liljenquist, D.</au><au>Odugbesan, O.</au><au>Bhargava, A.</au><au>Goland, R.</au><au>Weinstock, R.</au><aucorp>ASPIRE In-Home Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of Hypoglycemia in the ASPIRE In-Home Study and Effects of Automatic Suspension of Insulin Delivery</atitle><jtitle>Journal of diabetes science and technology</jtitle><addtitle>J Diabetes Sci Technol</addtitle><date>2015-05-18</date><risdate>2015</risdate><volume>9</volume><issue>5</issue><spage>1016</spage><epage>1020</epage><pages>1016-1020</pages><issn>1932-2968</issn><eissn>1932-2968</eissn><eissn>1932-3107</eissn><abstract>Background:
Hypoglycemia varies between patients with type 1 diabetes and is the main obstacle to therapy intensification. We investigated known and potential risk factors for hypoglycemia in subjects with type 1 diabetes.
Method:
In the ASPIRE In-Home study (NCT01497938), a randomized trial of the threshold suspend (TS) feature of sensor-augmented insulin pump (SAP) therapy, subjects’ propensity to nocturnal hypoglycemia (NH) was established in a 2-week run-in phase and assessed in a 3-month study phase via continuous glucose monitoring. Categorical variables were tested for association with NH rates in both phases.
Results:
Elevated rates of NH were significantly associated with baseline A1C ≤7%, with bolus insulin deliveries unassisted by the bolus estimation calculator, and with assignment to the control group during the study phase.
Conclusions:
Routine use of the TS feature and the bolus estimation calculator are strategies that may reduce the risk of NH.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>25986629</pmid><doi>10.1177/1932296815586014</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of diabetes science and technology, 2015-05, Vol.9 (5), p.1016-1020 |
| issn | 1932-2968 1932-2968 1932-3107 |
| language | eng |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SAGE Complete; PubMed Central |
| subjects | Blood Glucose - analysis Blood Glucose Self-Monitoring Diabetes Mellitus, Type 1 - blood Diabetes Mellitus, Type 1 - drug therapy Female Humans Hypoglycemia - blood Hypoglycemia - chemically induced Hypoglycemic Agents - administration & dosage Hypoglycemic Agents - adverse effects Hypoglycemic Agents - therapeutic use Insulin - administration & dosage Insulin - adverse effects Insulin - therapeutic use Insulin Infusion Systems Male Original |
| title | Predictors of Hypoglycemia in the ASPIRE In-Home Study and Effects of Automatic Suspension of Insulin Delivery |
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