Source:http://linkedlifedata.com/resource/pubmed/id/20393188
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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
27
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pubmed:dateCreated |
2010-4-15
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pubmed:abstractText |
Automated control of blood glucose (BG) concentration is a long-sought goal for type 1 diabetes therapy. We have developed a closed-loop control system that uses frequent measurements of BG concentration along with subcutaneous delivery of both the fast-acting insulin analog lispro and glucagon (to imitate normal physiology) as directed by a computer algorithm. The algorithm responded only to BG concentrations and incorporated a pharmacokinetic model for lispro. Eleven subjects with type 1 diabetes and no endogenous insulin secretion were studied in 27-hour experiments, which included three carbohydrate-rich meals. In six subjects, the closed-loop system achieved a mean BG concentration of 140 mg/dl, which is below the mean BG concentration target of < or =154 mg/dl recommended by the American Diabetes Association. There were no instances of treatment-requiring hypoglycemia. Five other subjects exhibited hypoglycemia that required treatment; however, these individuals had slower lispro absorption kinetics than the six subjects that did not become hypoglycemic. The time-to-peak plasma lispro concentrations of subjects that exhibited hypoglycemia ranged from 71 to 191 min (mean, 117 +/- 48 min) versus 56 to 72 min (mean, 64 +/- 6 min) in the group that did not become hypoglycemic (aggregate mean of 84 min versus 31 min longer than the algorithm's assumption of 33 min, P = 0.07). In an additional set of experiments, adjustment of the algorithm's pharmacokinetic parameters (time-to-peak plasma lispro concentration set to 65 min) prevented hypoglycemia in both groups while achieving an aggregate mean BG concentration of 164 mg/dl. These results demonstrate the feasibility of safe BG control by a bihormonal artificial endocrine pancreas.
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pubmed:grant | |
pubmed:commentsCorrections | |
pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:chemical | |
pubmed:status |
MEDLINE
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pubmed:month |
Apr
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pubmed:issn |
1946-6242
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pubmed:author | |
pubmed:issnType |
Electronic
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pubmed:day |
14
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pubmed:volume |
2
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
27ra27
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pubmed:dateRevised |
2011-11-17
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pubmed:meshHeading |
pubmed-meshheading:20393188-Adult,
pubmed-meshheading:20393188-Aged,
pubmed-meshheading:20393188-Blood Glucose,
pubmed-meshheading:20393188-Diabetes Mellitus, Type 1,
pubmed-meshheading:20393188-Drug Delivery Systems,
pubmed-meshheading:20393188-Female,
pubmed-meshheading:20393188-Glucagon,
pubmed-meshheading:20393188-Humans,
pubmed-meshheading:20393188-Insulin,
pubmed-meshheading:20393188-Insulin Lispro,
pubmed-meshheading:20393188-Male,
pubmed-meshheading:20393188-Middle Aged,
pubmed-meshheading:20393188-Pancreas, Artificial,
pubmed-meshheading:20393188-Young Adult
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pubmed:year |
2010
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pubmed:articleTitle |
A bihormonal closed-loop artificial pancreas for type 1 diabetes.
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pubmed:affiliation |
Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA.
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pubmed:publicationType |
Journal Article,
Clinical Trial,
Research Support, Non-U.S. Gov't,
Research Support, N.I.H., Extramural
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