Real-Time Hypoglycemia Prediction Suite Using Continuous Glucose Monitoring  

Oleh:

Dassau, Eyal ; Cameron, Fraser ; Hyunjin, Lee

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Diabetes Care vol. 33 no. 06 (Jun. 2010), page 1249-1254 .
Topik: hypoglycemia prediction algorithm (HPA); basal insulin

Ketersediaan

Perpustakaan FK Nomor Panggil: D05.K.2010.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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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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