No more hypoglycaemia on days with physical activity and unrestricted diet when using a closed‐loop system for 12 weeks : A post‐hoc secondary analysis of the multicentre randomized controlled Diabeloop WP7 trial Article - Mai 2021

Sylvia Franc, Pierre‐yves Benhamou, Sophie Borot, Lucy Chaillous, Brigitte Delemer, Maeva Doron, Bruno Guerci, Hélène Hanaire, Erik Huneker, Nathalie Jeandidier, Coralie Amadou, Eric Renard, Yves Reznik, Pauline Schaepelynck, Chantal Simon, Charles Thivolet, Claire Thomas, Patrick Hannaert, Guillaume Charpentier

Sylvia Franc, Pierre‐yves Benhamou, Sophie Borot, Lucy Chaillous, Brigitte Delemer, Maeva Doron, Bruno Guerci, Hélène Hanaire, Erik Huneker, Nathalie Jeandidier, Coralie Amadou, Eric Renard, Yves Reznik, Pauline Schaepelynck, Chantal Simon, Charles Thivolet, Claire Thomas, Patrick Hannaert, Guillaume Charpentier, « No more hypoglycaemia on days with physical activity and unrestricted diet when using a closed‐loop system for 12 weeks : A post‐hoc secondary analysis of the multicentre randomized controlled Diabeloop WP7 trial  », Diabetes, Obesity and Metabolism, mai 2021. ISSN 1462-8902

Abstract

Objective : To investigate the efficacy of the Diabeloop Generation-1 (DBLG1) closed-loop system to control the hypoglycaemia induced by physical activity (PA) in real-life conditions. Methods : This was a post-hoc analysis of the Diabeloop WP7 multicentre randomized controlled trial. Glycaemic outcomes were compared between days with and without PA in 56 patients with type 1 diabetes (T1D) using DBLG1 for 12 weeks. After the patient announces a PA, DBLG1 reduces insulin delivery and, if necessary, calculates the amount of preventive carbohydrates (CHO). Results : Daily time spent in the interstitial glucose range <70 mg/dL was not significantly different between days with and without PA (2.0 ± 1.5% versus 2.2 ± 1.1%) and this regardless of the intensity or duration of the PA. Preventive CHO intake recommended by the system was significantly higher in days with PA (41.1 ± 35.5 versus 21.8 ± 28.5 g/day ; P <0.0001), and insulin delivery was significantly lower (31.5 ± 10.5 versus 34.0 ± 10.5 U/day ; P <0.0001). The time spent in hyperglycaemia and the glycaemic variation coefficient increased significantly on days with PA. Conclusions : In real-life conditions, the use of DBLG1 avoids PA-induced hypoglycaemia. Insulin adjustments and preventive CHO recommendation may explain this therapeutic benefit.

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