Abstract | OBJECTIVE: The purpose of this study was to develop an advanced algorithm that detects pending hypoglycemia and then suspends basal insulin delivery. This approach can provide a solution to the problem of nocturnal hypoglycemia, a major concern of patients with diabetes. RESEARCH DESIGN AND METHODS: This real-time hypoglycemia prediction algorithm (HPA) combines five individual algorithms, all based on continuous glucose monitoring 1-min data. A predictive alarm is issued by a voting algorithm when a hypoglycemic event is predicted to occur in the next 35 min. The HPA system was developed using data derived from 21 Navigator studies that assessed Navigator function over 24 h in children with type 1 diabetes. We confirmed the function of the HPA using a separate dataset from 22 admissions of type 1 diabetic subjects. During these admissions, hypoglycemia was induced by gradual increases in the basal insulin infusion rate up to 180% from the subject's own baseline infusion rate. RESULTS Using a prediction horizon of 35 min, a glucose threshold of 80 mg/dl, and a voting threshold of three of five algorithms to predict hypoglycemia (defined as a FreeStyle plasma glucose readings <60 mg/dl), the HPA predicted 91% of the hypoglycemic events. When four of five algorithms were required to be positive, then 82% of the events were predicted. CONCLUSIONS: The HPA will enable automated insulin-pump suspension in response to a pending event that has been detected prior to severe immediate complications.
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Authors | Eyal Dassau, Fraser Cameron, Hyunjin Lee, B Wayne Bequette, Howard Zisser, Lois Jovanovic, H Peter Chase, Darrell M Wilson, Bruce A Buckingham, Francis J Doyle 3rd |
Journal | Diabetes care
(Diabetes Care)
Vol. 33
Issue 6
Pg. 1249-54
(Jun 2010)
ISSN: 1935-5548 [Electronic] United States |
PMID | 20508231
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Adolescent
- Blood Glucose
(analysis)
- Child
- Child, Preschool
- Diabetes Mellitus, Type 1
(blood, drug therapy)
- Female
- Humans
- Hypoglycemia
(blood, drug therapy)
- Insulin Infusion Systems
- Male
- Pancreas, Artificial
- Predictive Value of Tests
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