title: The use of an automated, portable glucose control system for overnight glucose control in adolescents and young adults with type 1 diabetes.
abstract: OBJECTIVE
  A key milestone in progress towards providing an efficacious and safe closed-loop artificial pancreas system for outpatient use is the development of fully automated, portable devices with fault detection capabilities to ensure patient safety. The ability to remotely monitor the operation of the closed-loop system would facilitate future physician-supervised home studies.
  
  
  METHODS
  This study was designed to investigate the efficacy and safety of a fully automated, portable, closed-loop system. The Medtronic Portable Glucose Control System (PGCS) consists of two subcutaneous glucose sensors, a control algorithm based on proportional-integral-derivative with insulin feedback operating from a BlackBerry Storm smartphone platform, Bluetooth radiofrequency translator, and an off-the-shelf Medtronic Paradigm Veo insulin pump. Participants with type 1 diabetes using insulin pump therapy underwent two consecutive nights of in-clinic, overnight, closed-loop control after a baseline open-loop assessment.
  
  
  RESULTS
  Eight participants attended for 16 overnight studies. The PGCS maintained mean overnight plasma glucose levels of 6.4 ± 1.7 mmol/L (115 ± 31 mg/dL). The proportion of time with venous plasma glucose <3.9, between 3.9 and 8 (70 and 144 mg/dL), and >8 mmol/L was 7, 78, and 15%, respectively. The proportion of time the sensor glucose values were maintained between 3.9 and 8 mmol/L was greater for closed-loop than open-loop (84.5 vs. 46.7%; P < 0.0001), and time spent <3.3 mmol/L was also reduced (0.9 vs. 3%; P < 0.0001).
  
  
  CONCLUSIONS
  These results suggest that the PGCS, an automated closed-loop device, is safe and effective in achieving overnight glucose control in patients with type 1 diabetes.
authors.affiliation: Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: O'Grady
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Retterath
authors.forename: D Barry
authors.initials: DB
authors.lastname: Keenan
authors.forename: Natalie
authors.initials: N
authors.lastname: Kurtz
authors.forename: Martin
authors.initials: M
authors.lastname: Cantwell
authors.forename: Glenn
authors.initials: G
authors.lastname: Spital
authors.forename: Michael N
authors.initials: MN
authors.lastname: Kremliovsky
authors.forename: Anirban
authors.initials: A
authors.lastname: Roy
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Davis
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Jones
authors.forename: Trang T
authors.initials: TT
authors.lastname: Ly
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D001786:Blood Glucose / Q000187:drug effects*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use*; D008297:Male; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin