Run-to-run control of meal-related insulin dosing.
BACKGROUND
This study was designed to determine if it was feasible to use a run-to-run algorithm to improve postprandial glucose concentrations in individuals with type 1 diabetes mellitus (T1DM).


METHODS
Fourteen subjects were recruited for this 10-week study. During the initial phases of the study, the following information was derived for each subject: basal insulin infusion rates, insulin-to-carbohydrate ratios, insulin correction factors for hyperglycemia, and insulin sensitivities. During the final phases, the algorithm was used to suggest preprandial insulin doses, with a goal of bringing the postprandial glucose into a predetermined target range within 3-7 days.


RESULTS
In the single-meal phase (phase 5), 33% of the subject-meal responses were convergent in 3-4 days to a clinically acceptable range, 33% always stayed in range, and 33% had divergent responses, incorrect sensitivities, and/or other mitigating circumstances. In the three-meal phase (phase 6), 41% of the subject-meal responses were convergent in 3-4 days to a clinically acceptable range, 26% were always in range, and 33% had divergent responses, incorrect sensitivities, and/or other mitigating circumstances.


CONCLUSIONS
Overall, we were able to safely demonstrate that run-to-run control can be used to manage meal-related insulin in subjects with T1DM.
Zisser
Howard
H
Sansum Diabetes Research Institute, University of California, Santa Barbara, California 93105, USA. hzisser@sansum.org
Jovanovic
Lois
L
Doyle
Frank
F
Ospina
Paulina
P
Owens
Camelia
C
D000465:Algorithms; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D004435:Eating / Q000502:physiology*; D006801:Humans; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D019518:Postprandial Period
D001786:Blood Glucose; D007328:Insulin