title: Automated Overnight Closed-Loop Control Using a Proportional-Integral-Derivative Algorithm with Insulin Feedback in Children and Adolescents with Type 1 Diabetes at Diabetes Camp.
abstract: This study determined the feasibility and efficacy of an automated proportional-integral-derivative with insulin feedback (PID-IFB) controller in overnight closed-loop (OCL) control of children and adolescents with type 1 diabetes over multiple days in a diabetes camp setting.
  
  
  
  The Medtronic (Northridge, CA) Android™ (Google, Mountain View, CA)-based PID-IFB system consists of the Medtronic Minimed Revel™ 2.0 pump and Enlite™ sensor, a control algorithm residing on an Android phone, a translator, and remote monitoring capabilities. An inpatient study was completed for 16 participants to determine feasibility. For the camp study, subjects with type 1 diabetes were randomized to either OCL or sensor-augmented pump therapy (control conditions) per night for up to 6 nights at diabetes camp.
  
  
  
  During the camp study, 21 subjects completed 50 OCL nights and 52 control nights. Based on intention to treat, the median time spent in range, from 70 to 150 mg/dL, was greater during OCL at 66.4% (n = 55) versus 50.6% (n = 52) during the control period (P = 0.004). A per-protocol analysis allowed for assessment of algorithm performance with the median percentage time in range, 70-150 mg/dL, being 75.5% (n = 37) for OCL versus 47.6% (n = 32) for the control period (P < 0.001). There was less time spent in the hypoglycemic ranges <60 mg/dL and <70 mg/dL during OCL compared with the control period (P = 0.003 and P < 0.001, respectively).
  
  
  
  The PID-IFB controller is effective in improving time spent in range as well as reducing nocturnal hypoglycemia during the overnight period in children and adolescents with type 1 diabetes in a diabetes camp setting.
authors.affiliation: 1 Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine , Stanford, California.|2 School of Paediatrics and Child Health, The University of Western Australia , Perth, Western Australia, Australia .
authors.forename: Trang T
authors.initials: TT
authors.lastname: Ly
authors.affiliation: 3 Medtronic Minimed , Northridge, California.
authors.forename: D Barry
authors.initials: DB
authors.lastname: Keenan
authors.affiliation: 3 Medtronic Minimed , Northridge, California.
authors.forename: Anirban
authors.initials: A
authors.lastname: Roy
authors.affiliation: 3 Medtronic Minimed , Northridge, California.
authors.forename: Jino
authors.initials: J
authors.lastname: Han
authors.affiliation: 3 Medtronic Minimed , Northridge, California.
authors.forename: Benyamin
authors.initials: B
authors.lastname: Grosman
authors.affiliation: 3 Medtronic Minimed , Northridge, California.
authors.forename: Martin
authors.initials: M
authors.lastname: Cantwell
authors.affiliation: 3 Medtronic Minimed , Northridge, California.
authors.forename: Natalie
authors.initials: N
authors.lastname: Kurtz
authors.affiliation: 1 Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine , Stanford, California.
authors.forename: Rie
authors.initials: R
authors.lastname: von Eyben
authors.affiliation: 1 Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine , Stanford, California.
authors.forename: Paula
authors.initials: P
authors.lastname: Clinton
authors.affiliation: 1 Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine , Stanford, California.
authors.forename: Darrell M
authors.initials: DM
authors.lastname: Wilson
authors.affiliation: 1 Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine , Stanford, California.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Buckingham
mesh_terms: D000293:Adolescent; D000465:Algorithms; D001331:Automation; D001786:Blood Glucose / Q000032:analysis; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation*; D040421:Cell Phone; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D005240:Feasibility Studies; D005246:Feedback; D005260:Female; D006801:Humans; D007297:Inpatients; D007332:Insulin Infusion Systems; D008297:Male; D063731:Mobile Applications; D010353:Patient Education as Topic
chemical_list: D001786:Blood Glucose