Department of Biomedical Engineering, McGill University, Montreal, Quebec, Canada.
Department of Electrical and Computer Engineering, McGill University, Montreal, Quebec, Canada.
Diabetes Care. 2021 Feb;44(2):604-606. doi: 10.2337/dc20-1232. Epub 2020 Dec 4.
We developed a meal detection algorithm for the artificial pancreas (AP+MDA) that detects unannounced meals and delivers automatic insulin boluses.
We conducted a randomized crossover trial in 11 adolescents aged 12-18 years with HbA ≥7.5% who missed one or more boluses in the past 6 months. We compared ) continuous subcutaneous insulin infusion (CSII), ) artificial pancreas (AP), and ) AP+MDA. Participants underwent three 9-h interventions involving breakfast with a bolus and lunch without a bolus.
In AP+MDA, the meal detection time was 40.0 (interquartile range 40.0-57.5) min. Compared with CSII, AP+MDA decreased the 4-h postlunch incremental area under the curve (iAUC) from 24.1 ± 9.5 to 15.4 ± 8.0 h ⋅ mmol/L ( = 0.03). iAUC did not differ between AP+MDA and AP (19.6 ± 10.4 h ⋅ mmol/L, = 0.21) or between AP and CSII ( = 0.33). The AP+MDA reduced time >10 mmol/L (58.0 ± 26.6%) compared with CSII (79.6 ± 27.5%, = 0.02) and AP (74.2 ± 20.6%, = 0.047).
The AP+MDA improved glucose control after an unannounced meal.
我们开发了一种用于人工胰腺（AP+MDA）的进餐检测算法，该算法可检测未通知的进餐并自动给予胰岛素推注。
我们在 11 名年龄在 12-18 岁、HbA1c≥7.5%、过去 6 个月漏注 1 次或多次胰岛素的青少年中进行了一项随机交叉试验。我们比较了）持续皮下胰岛素输注（CSII）、）人工胰腺（AP）和）AP+MDA。参与者接受了 3 项 9 小时的干预，涉及带推注的早餐和不带推注的午餐。
在 AP+MDA 中，进餐检测时间为 40.0（四分位间距 40.0-57.5）分钟。与 CSII 相比，AP+MDA 使午餐后 4 小时的增量曲线下面积（iAUC）从 24.1±9.5 降至 15.4±8.0 h ⋅ mmol/L（ = 0.03）。AP+MDA 与 AP（19.6±10.4 h ⋅ mmol/L， = 0.21）或 AP 与 CSII（ = 0.33）之间的 iAUC 无差异。AP+MDA 使时间＞10 mmol/L 的时间减少（58.0±26.6%），与 CSII（79.6±27.5%， = 0.02）和 AP（74.2±20.6%， = 0.047）相比。
AP+MDA 改善了未通知进餐后的血糖控制。
