1
|
Deshpande S, Doyle FJ, Dassau E. Glucose Rate-of-Change and Insulin-on-Board Jointly Weighted Zone Model Predictive Control. IEEE TRANSACTIONS ON CONTROL SYSTEMS TECHNOLOGY : A PUBLICATION OF THE IEEE CONTROL SYSTEMS SOCIETY 2023; 31:2261-2274. [PMID: 38525198 PMCID: PMC10958373 DOI: 10.1109/tcst.2023.3291573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
We present design and evaluation of closed-loop insulin delivery using zone model predictive control (MPC) featuring an adaptive weighting scheme to address prolonged hyperglycemia due to changes in insulin sensitivity, underdelivery from profile mismatch, and meal composition. In the MPC cost function, the penalty on predicted glucose deviation from the upper zone boundary is weighted by a joint function of predicted glucose rate-of-change (ROC) and insulin-on-board (IOB). The asymmetric weighting gradually increases when glucose ROC and IOB were jointly low, independent of glucose magnitude, to limit hyperglycemia while aggressively reduces for negative glucose ROC to avoid hypoglycemia. The proposed controller was evaluated using two simulation scenarios: an induced resistance scenario and a nominal scenario to highlight the performance over a reference zone MPC with glucose ROC weighting only. The continuous adaption scheme resulted in consistent improvement for the entire glucose range without incurring additional risk of hypoglycemia. For the induced resistance and no feedforward bolus scenario, the percent time in 70-180 mg/dL was higher (53.5% versus 48.9%, p<0.001) with larger improvement in the overnight percent time in tighter glucose range 70-140 mg/dL (70.9% versus 52.9%, p<0.001). The results from extensive simulations, as well as clinical validation in three different outpatient studies demonstrate the utility and safety of the proposed zone MPC.
Collapse
Affiliation(s)
- Sunil Deshpande
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA
| | - Francis J Doyle
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA
| | - Eyal Dassau
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA
| |
Collapse
|
2
|
Rubin D, Bosy-Westphal A, Kabisch S, Kronsbein P, Simon MC, Tombek A, Weber KS, Skurk T. Nutritional Recommendations for People with Type 1 Diabetes Mellitus. Exp Clin Endocrinol Diabetes 2023; 131:33-50. [PMID: 36638807 DOI: 10.1055/a-1946-3753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Diana Rubin
- Vivantes Hospital Spandau, Berlin, Germany.,Vivantes Humboldt Hospital, Berlin, Germany
| | - Anja Bosy-Westphal
- Institute of Human Nutrition, Faculty of Agriculture and Nutritional Sciences, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Stefan Kabisch
- Department of Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.,German Center for Diabetes Research (DZD), Munich, Germany
| | - Peter Kronsbein
- Faculty of Nutrition and Food Sciences, Niederrhein University of Applied Sciences, Mönchengladbach, Germany
| | - Marie-Christine Simon
- Institute of Nutrition and Food Sciences, Rhenish Friedrich Wilhelm University of Bonn, Bonn, Germany
| | - Astrid Tombek
- Diabetes Center Bad Mergentheim, Bad Mergentheim, Germany
| | - Katharina S Weber
- Institute for Epidemiology, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Thomas Skurk
- ZIEL - Institute for Food & Health, Technical University Munich, Freising, Germany
| |
Collapse
|
3
|
Papakonstantinou E, Galanopoulos K, Kapetanakou AE, Gkerekou M, Skandamis PN. Short-Term Effects of Traditional Greek Meals: Lentils with Lupins, Trahana with Tomato Sauce and Halva with Currants and Dried Figs on Postprandial Glycemic Responses-A Randomized Clinical Trial in Healthy Humans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11502. [PMID: 36141773 PMCID: PMC9517682 DOI: 10.3390/ijerph191811502] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/31/2022] [Accepted: 09/10/2022] [Indexed: 06/16/2023]
Abstract
Low glycemic index (GI) diets have been associated with decreased chronic disease risk. In a randomized, cross-over study we investigated the GI and glycemic response to three traditional Greek mixed meals: Lentils, Trahana, and Halva. Twelve healthy, fasting individuals received isoglucidic test meals (25 g available carbohydrate) and 25 g glucose reference, in random order. GI was calculated and capillary blood glucose (BG) samples were collected at 0-120 min after meal consumption. Subjective appetite ratings were assessed. All three tested meals provided low GI values. Lentils GI was 27 ± 5, Trahana GI was 42 ± 6, and Halva GI was 52 ± 7 on glucose scale. Peak BG values were lowest for Lentils, followed by Trahana and then by Halva (p for all <0.05). Compared to the reference food, BG concentrations were significantly lower for all meals at all time-points (p for all <0.05). Lentils provided lower glucose concentrations at 30 and 45 min compared to Trahana (p for all <0.05) and at 30, 45, and 60 min compared to Halva (p for all <0.05). BG concentrations did not differ between Trahana and Halva at all time points. No differences were observed for fasting BG, time to peak rise for BG, and subjective appetite ratings. In conclusion, all three mixed meals attenuated postprandial glycemic response in comparison to glucose, which may offer advantages to glycemic control.
Collapse
Affiliation(s)
- Emilia Papakonstantinou
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 75 Iera Odos, 18855 Athens, Greece
| | - Konstantinos Galanopoulos
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 75 Iera Odos, 18855 Athens, Greece
- Laboratory of Food Quality Control and Hygiene, Department of Food Science and Human Nutrition, School of Food Science and Human Nutrition, 75 Iera Odos, 18855 Athens, Greece
| | - Anastasia E. Kapetanakou
- Laboratory of Food Quality Control and Hygiene, Department of Food Science and Human Nutrition, School of Food Science and Human Nutrition, 75 Iera Odos, 18855 Athens, Greece
| | - Maria Gkerekou
- Laboratory of Food Quality Control and Hygiene, Department of Food Science and Human Nutrition, School of Food Science and Human Nutrition, 75 Iera Odos, 18855 Athens, Greece
| | - Panagiotis N. Skandamis
- Laboratory of Food Quality Control and Hygiene, Department of Food Science and Human Nutrition, School of Food Science and Human Nutrition, 75 Iera Odos, 18855 Athens, Greece
| |
Collapse
|
4
|
Dietary patterns and diabetes risk in Southern Chinese in Guangxi Zhuang autonomous region. Int J Diabetes Dev Ctries 2022. [DOI: 10.1007/s13410-022-01077-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
5
|
Papakonstantinou E, Xaidara M, Siopi V, Giannoglou M, Katsaros G, Theodorou G, Maratou E, Poulia KA, Dimitriadis GD, Skandamis PN. Effects of Spaghetti Differing in Soluble Fiber and Protein Content on Glycemic Responses in Humans: A Randomized Clinical Trial in Healthy Subjects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053001. [PMID: 35270698 PMCID: PMC8909947 DOI: 10.3390/ijerph19053001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 02/04/2023]
Abstract
This randomized, single blind, cross-over study investigated the glycemic responses to three spaghetti No 7 types differing in dietary protein and soluble fiber content. Fourteen clinically and metabolically healthy, fasting individuals (25 ± 1 years; ten women; BMI 23 ± 1 kg/m2) received isoglucidic test meals (50 g available carbohydrate) and 50 g glucose reference, in random order. GI was calculated using the FAO/WHO method. Capillary blood glucose and salivary insulin samples were collected at 0, 15, 30, 45, 60, and 120 min. Subjective appetite ratings (hunger, fullness, and desire to eat) were assessed by visual analogue scales (VAS, 100 mm) at baseline and 120 min. All three spaghetti types (regular, whole wheat, and high soluble fiber–low carbohydrates) provided low GI values (33, 38, and 41, respectively, on glucose scale) and lower peak glucose values compared to glucose or white bread. No differences were observed between spaghetti No 7 types for fasting glucose, fasting and post-test-meal insulin concentrations, blood pressure (systolic and diastolic), and subjective appetite. Conclusions: all spaghetti No 7 types, regardless of soluble fiber and/or protein content, attenuated postprandial glycemic response, which may offer advantages to glycemic control.
Collapse
Affiliation(s)
- Emilia Papakonstantinou
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 11855 Athens, Greece; (M.X.); (V.S.); (K.-A.P.)
- Correspondence: ; Tel.: +30-2105294967
| | - Marina Xaidara
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 11855 Athens, Greece; (M.X.); (V.S.); (K.-A.P.)
| | - Vassiliki Siopi
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 11855 Athens, Greece; (M.X.); (V.S.); (K.-A.P.)
| | - Marianna Giannoglou
- Institute of Technology of Agricultural Products, Hellenic Agricultural Organization “DEMETER”, 14123 Athens, Greece; (M.G.); (G.K.)
| | - George Katsaros
- Institute of Technology of Agricultural Products, Hellenic Agricultural Organization “DEMETER”, 14123 Athens, Greece; (M.G.); (G.K.)
| | - Georgios Theodorou
- Laboratory of Animal Breeding and Husbandry, Department of Animal Science, School of Animal Biosciences, Agricultural University of Athens, 11855 Athens, Greece;
| | - Eirini Maratou
- Department of Clinical Biochemistry, “Attikon” University General Hospital, National and Kapodistrian University of Athens, Haidari, 12462 Athens, Greece;
| | - Kalliopi-Anna Poulia
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 11855 Athens, Greece; (M.X.); (V.S.); (K.-A.P.)
| | - George D. Dimitriadis
- Sector of Medicine, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece;
| | - Panagiotis N. Skandamis
- Laboratory of Food Quality Control and Hygiene, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 11855 Athens, Greece;
| |
Collapse
|
6
|
Pugnaloni S, Alia S, Gabrielli M, Di Paolo A, Turco I, Mazzanti L, Orsini R, Vignini A, Ferretti G. Senatore cappelli ( Triticum turgidum ssp. durum) pasta: a study on the nutritional quality of whole grains and its physical form. Int J Food Sci Nutr 2022; 73:451-459. [PMID: 35016589 DOI: 10.1080/09637486.2021.2025212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Pasta is one of the components of the Mediterranean Diet, despite considerable attention given, its use is still debated. Several studies encouraged the consumption of whole grain because of its many properties and the positive association between refined carbohydrates and insulin resistance, by measuring the Glycaemic Index (GI), an indicator of the physiological effects of a carbohydrate meal. In this study, the GI and polyphenol content of Senatore Cappelli (Triticum turgidum ssp. durum) pasta were evaluated. Using spectrophotometric methods, total polyphenols and flavonoids were found to be 113.5 mg/100 g and 52.96 mg/100 g, respectively. To measure the GI, a standard assay was performed, and values of 47.9 ± 5.2 for long format pasta and 68.5 ± 4.6 for short format pasta were obtained. The present study confirms the presence of polyphenols and flavonoids in pasta Senatore Cappelli. The value of GI is influenced by the pasta shape. These informations could provide valuable data for practitioners preparing personalised diets.
Collapse
Affiliation(s)
- Sofia Pugnaloni
- Department of Clinical Sciences, Section of Biochemistry, Biology and Physics, Università Politecnica delle Marche, Ancona, Italy
| | - Sonila Alia
- Department of Clinical Sciences, Section of Biochemistry, Biology and Physics, Università Politecnica delle Marche, Ancona, Italy
| | - Marcello Gabrielli
- Department of Clinical Sciences, School of Specialization in Clinical Nutrition, Università Politecnica delle Marche, Ancona, Italy
| | - Alice Di Paolo
- Department of Clinical Sciences, Section of Biochemistry, Biology and Physics, Università Politecnica delle Marche, Ancona, Italy
| | - Imma Turco
- Department of Clinical Sciences, Section of Biochemistry, Biology and Physics, Università Politecnica delle Marche, Ancona, Italy
| | - Laura Mazzanti
- Department of Clinical Sciences, Section of Biochemistry, Biology and Physics, Università Politecnica delle Marche, Ancona, Italy
| | - Roberto Orsini
- Department of Agricultural, Food and Environmental Sciences (D3A), Agronomy and Crop Science Section, Università Politecnica delle Marche, Ancona, Italy
| | - Arianna Vignini
- Department of Clinical Sciences, Section of Biochemistry, Biology and Physics, Università Politecnica delle Marche, Ancona, Italy.,Research Center of Health Education and Health Promotion, Università Politecnica delle Marche, Ancona, Italy
| | - Gianna Ferretti
- Department of Clinical Sciences, Section of Biochemistry, Biology and Physics, Università Politecnica delle Marche, Ancona, Italy.,Research Center of Health Education and Health Promotion, Università Politecnica delle Marche, Ancona, Italy
| |
Collapse
|
7
|
Rubin D, Bosy-Westphal A, Kabisch S, Kronsbein P, Simon MC, Tombek A, Weber K, Skurk T. Empfehlungen zur Ernährung von Personen mit Typ-1-Diabetes mellitus. DIABETOL STOFFWECHS 2021. [DOI: 10.1055/a-1515-8766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Diana Rubin
- Vivantes Klinikum Spandau, Berlin
- Vivantes Humboldt Klinikum, Berlin
| | - Anja Bosy-Westphal
- Institut für Humanernährung, Agrar- und Ernährungswissenschaftliche Fakultät, Christian-Albrechts-Universität zu Kiel, Kiel
| | - Stefan Kabisch
- Deutsches Zentrum für Diabetesforschung (DZD), München
- Else Kröner-Fresenius-Zentrum für Ernährungsmedizin, Technische Universität München, Freising
| | - Peter Kronsbein
- Fachbereich Oecotrophologie, Hochschule Niederrhein, Campus Mönchengladbach
| | - Marie-Christine Simon
- Institut für Ernährungs- und Lebensmittelwissenschaften, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn
| | | | - Katharina Weber
- Institut für Epidemiologie, Christian-Albrechts-Universität zu Kiel, Kiel
| | - Thomas Skurk
- ZIEL – Institute for Food & Health, Technische Universität München, München
- Else Kröner-Fresenius-Zentrum für Ernährungsmedizin, Technische Universität München, Freising
| | | |
Collapse
|
8
|
Golzarand M, Toolabi K, Eskandari Delfan S, Mirmiran P. The effect of brown rice compared to white rice on adiposity indices, lipid profile, and glycemic markers: a systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr 2021; 62:7395-7412. [PMID: 33905269 DOI: 10.1080/10408398.2021.1914541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A few randomized controlled trials (RCTs) have assessed the effect of brown rice consumption on metabolic parameters compared to white rice, with inconsistent findings. Therefore, the present systematic review and meta-analysis was designed to evaluate the effect of brown rice on adiposity indices, lipid profile, and glycemic markers in adult subjects compared to white rice. In this study, PubMed/Medline, Scopus, Web of Sciences, and Embase databases were comprehensively searched until March 2021. Thirteen RCTs were selected and then included in the meta-analysis. As reported, brown rice significantly reduced weight by -1.63 kg (95% CI: -2.15 to -1.11, I2=97%, n = 6), body mass index (BMI) by -0.58 kg/m2 (95% CI: -0.78 to -0.37, I2=96%, n = 6), and waist circumference by -2.56 cm (95% CI: -4.86 to -0.26, I2=88%, n = 5) compared with white rice. Moreover, it had no significant effect on lipid profile and glycemic markers. Besides, pre-germinated brown rice significantly declined weight (-1.75 kg, 95% CI: -2.70 to -0.81, I2=99%, n = 4), total cholesterol (-24.22 mg/dl, 95% CI: -33.03 to -15.41, I2=78%, n = 5), triglyceride (TG) (-43.28 mg/dl, 95% CI: -74.05 to -12.50, I2=90%, n = 5), low-density lipoprotein (LDL) (-20.05 mg/dl, 95% CI: -29.57 to -10.52, I2=71%, n = 5), and fasting blood glucose (FBG) (-15.83 mg/dl, 95% CI: -25.20 to -6.46, I2=91%, n = 5). In accordance with Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, the certainly of the included evidence was low and very low. The results of the present study indicate that, brown rice has anti-obesity effects in comparison with white rice; however, it has no beneficial effects on lipid profile and glycemic markers. Contrary to brown rice, it was shown that, pre-germinated brown rice significantly decreases body weight and improves lipid profile and FBG levels compared to white rice. Accordingly, our results indicate that, pre-germinated brown rice has better functional effects on promoting lipid profile and FBG compared to brown rice.
Collapse
Affiliation(s)
- Mahdieh Golzarand
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Karamollah Toolabi
- Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
9
|
Normal Versus Slowly Processed Pasta and Post-Prandial Glucose Homeostasis in Healthy Subjects: A Pilot Study. Nutrients 2021; 13:nu13020678. [PMID: 33672666 PMCID: PMC7924401 DOI: 10.3390/nu13020678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/04/2021] [Accepted: 02/18/2021] [Indexed: 11/29/2022] Open
Abstract
Nutritional science is gaining increasing attention due to the implicit potential to prevent cardio-metabolic diseases. It is also becoming clear that food-making process might influence the metabolic response to the meal. We have conducted a proof-of-concept study to investigate whether slowly processed pasta might positively impact glucose homeostasis. A total of 14 healthy male volunteers underwent two different mixed-meal tests in a randomized order. One meal was composed of 100 g of normally processed pasta and the other 100 g of slowly processed pasta. Each meal was completed with 10 g of olive oil and 10 g of parmesan cheese. Glucose, insulin, and incretin post-prandial responses were assessed at 15, 30, 60, 90, 120, 150, and 180 min. Glucose tolerance, insulin, and incretin response were unaffected by the two different pasta types. However, a slight difference was evident in the shape of the curve of post-prandial insulin (i.e., mildly delayed with the slowly processed pasta). Despite the common belief of a different impact of normally processed and slowly processed pasta on glucose metabolism, they show a superimposable post-prandial metabolic response after a single meal in male healthy individuals. Further studies are required to confirm these results also in chronic, real-life settings and then to translate them to metabolically impaired individuals.
Collapse
|
10
|
Rubin D, Bosy-Westphal A, Kabisch S, Kronsbein P, Simon MC, Tombek A, Weber KS, Skurk T. Nutritional Recommendations for People with Type 1 Diabetes Mellitus. Exp Clin Endocrinol Diabetes 2020; 129:S27-S43. [PMID: 33374025 DOI: 10.1055/a-1284-6036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Diana Rubin
- Vivantes Hospital Spandau, Berlin, Germany.,Vivantes Humboldt Hospital, Berlin, Germany
| | - Anja Bosy-Westphal
- Institute of Human Nutrition, Faculty of Agriculture and Nutritional Sciences, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Stefan Kabisch
- German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany
| | - Peter Kronsbein
- Faculty of Nutrition and Food Sciences, Niederrhein University of Applied Sciences, Campus Mönchengladbach, Germany
| | - Marie-Christine Simon
- Institute of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | | | - Katharina S Weber
- Institute for Epidemiology, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Thomas Skurk
- ZIEL - Institute for Food & Health, Technical University Munich, Munich, Germany
| |
Collapse
|
11
|
Deshpande S, Pinsker JE, Church MM, Piper M, Andre C, Massa J, Doyle III FJ, Eisenberg DM, Dassau E. Randomized Crossover Comparison of Automated Insulin Delivery Versus Conventional Therapy Using an Unlocked Smartphone with Scheduled Pasta and Rice Meal Challenges in the Outpatient Setting. Diabetes Technol Ther 2020; 22:865-874. [PMID: 32319791 PMCID: PMC7757622 DOI: 10.1089/dia.2020.0022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background: Automated Insulin Delivery (AID) hybrid closed-loop systems have not been well studied in the context of prescribed meals. We evaluated performance of our interoperable artificial pancreas system (iAPS) in the at-home setting, running on an unlocked smartphone, with scheduled meal challenges in a randomized crossover trial. Methods: Ten adults with type 1 diabetes completed 2 weeks of AID-based control and 2 weeks of conventional therapy in random order where they consumed regular pasta or extra-long grain white rice as part of a complete dinner meal on six different occasions in both arms (each meal thrice in random order). Surveys assessed satisfaction with AID use. Results: Postprandial differences in conventional therapy were 10,919.0 mg/dL × min (95% confidence interval [CI] 3190.5-18,648.0, P = 0.009) for glucose area under the curve (AUC) and 40.9 mg/dL (95% CI 4.6-77.3, P = 0.03) for peak continuous glucose monitor glucose, with rice showing greater increases than pasta. White rice resulted in a lower estimate over pasta by a factor of 0.22 (95% CI 0.08-0.63, P = 0.004) for AUC under 70 mg/dL. These glycemic differences in both meal types were reduced under AID-based control and were not statistically significant, where 0-2 h insulin delivery decreased by 0.45 U for pasta (P = 0.001) and by 0.27 U for white rice (P = 0.01). Subjects reported high overall satisfaction with the iAPS. Conclusions: The AID system running on an unlocked smartphone improved postprandial glucose control over conventional therapy in the setting of challenging meals in the outpatient setting. Clinical Trial Registry: clinicaltrials.gov NCT03767790.
Collapse
Affiliation(s)
- Sunil Deshpande
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts, USA
- Sansum Diabetes Research Institute, Santa Barbara, California, USA
| | | | - Mei Mei Church
- Sansum Diabetes Research Institute, Santa Barbara, California, USA
| | - Molly Piper
- Sansum Diabetes Research Institute, Santa Barbara, California, USA
| | - Camille Andre
- Sansum Diabetes Research Institute, Santa Barbara, California, USA
| | - Jennifer Massa
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Francis J. Doyle III
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts, USA
- Sansum Diabetes Research Institute, Santa Barbara, California, USA
| | - David M. Eisenberg
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Eyal Dassau
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts, USA
- Sansum Diabetes Research Institute, Santa Barbara, California, USA
- Joslin Diabetes Center, Boston, Massachusetts, USA
- Address correspondence to: Eyal Dassau, PhD, Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St., Rm. 317, Cambridge, MA 02138, USA
| |
Collapse
|
12
|
Rubin D, Bosy-Westphal A, Kabisch S, Kronsbein P, Simon MC, Tombek A, Weber K, Skurk T. Empfehlungen zur Ernährung von Personen mit Typ-1-Diabetes mellitus. DIABETOL STOFFWECHS 2020. [DOI: 10.1055/a-1245-5623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Diana Rubin
- Vivantes Klinikum Spandau, Berlin
- Vivantes Humboldt Klinikum, Berlin
| | - Anja Bosy-Westphal
- Institut für Humanernährung, Agrar- und Ernährungswissenschaftliche Fakultät, Christian-Albrechts-Universität zu Kiel, Kiel
| | - Stefan Kabisch
- Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke, Potsdam
| | - Peter Kronsbein
- Fachbereich Oecotrophologie, Hochschule Niederrhein, Campus Mönchengladbach
| | - Marie-Christine Simon
- Institut für Ernährungs- und Lebensmittelwissenschaften, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn
| | | | - Katharina Weber
- Institut für Epidemiologie, Christian-Albrechts-Universität zu Kiel, Kiel
| | - Thomas Skurk
- ZIEL – Institute for Food & Health, Technische Universität München, München
| | | |
Collapse
|