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Closed-loop in children with type 1 diabetes: specific challenges.
Diabetes Res Clin Pract. 2011 Aug; 93 Suppl 1:S131-5.DR

Abstract

OBJECTIVE

To review challenges and opportunities related to closed-loop glucose control in children with type 1 diabetes (T1D).

RESEARCH DESIGN AND METHODS

During closed-loop glucose control, insulin infusion rates on a subcutaneous insulin pump are adjusted by a control algorithm according to subcutaneous glucose sensor readings. A literature review is performed and personal experience of work with closed-loop systems at the University of Cambridge, UK, is presented.

RESULTS

The main challenges in the management of T1D in children are identified together with a summary of current therapeutics options. Review of the literature recognises hypoglycaemia as a limiting factor for the attainment of optimal glycaemic control, primarily in children. Additional specific confounding issues include unpredictable eating and exercise patterns especially in the youngest age group. Closed-loop systems might be particularly helpful, but have to consider increased insulin sensitivity, lower insulin doses, and human factors such as size and usability of closed-loop components.

CONCLUSIONS

Closed-loop systems may represent an alternative treatment option to achieve target glucose levels whilst reducing the risk of hypoglycaemia in children with T1D.

Authors+Show Affiliations

Department of Paediatrics, Uniuersity of Cambridge, Hills Road, Cambridge CB2 OQQ, UK.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

21864745

Citation

Elleri, Daniela, et al. "Closed-loop in Children With Type 1 Diabetes: Specific Challenges." Diabetes Research and Clinical Practice, vol. 93 Suppl 1, 2011, pp. S131-5.
Elleri D, Allen JM, Dunger DB, et al. Closed-loop in children with type 1 diabetes: specific challenges. Diabetes Res Clin Pract. 2011;93 Suppl 1:S131-5.
Elleri, D., Allen, J. M., Dunger, D. B., & Hovorkea, R. (2011). Closed-loop in children with type 1 diabetes: specific challenges. Diabetes Research and Clinical Practice, 93 Suppl 1, S131-5. https://doi.org/10.1016/S0168-8227(11)70029-8
Elleri D, et al. Closed-loop in Children With Type 1 Diabetes: Specific Challenges. Diabetes Res Clin Pract. 2011;93 Suppl 1:S131-5. PubMed PMID: 21864745.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Closed-loop in children with type 1 diabetes: specific challenges. AU - Elleri,Daniela, AU - Allen,Janet M, AU - Dunger,David B, AU - Hovorkea,Roman, PY - 2011/8/26/entrez PY - 2011/9/1/pubmed PY - 2012/1/31/medline SP - S131 EP - 5 JF - Diabetes research and clinical practice JO - Diabetes Res Clin Pract VL - 93 Suppl 1 N2 - OBJECTIVE: To review challenges and opportunities related to closed-loop glucose control in children with type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS: During closed-loop glucose control, insulin infusion rates on a subcutaneous insulin pump are adjusted by a control algorithm according to subcutaneous glucose sensor readings. A literature review is performed and personal experience of work with closed-loop systems at the University of Cambridge, UK, is presented. RESULTS: The main challenges in the management of T1D in children are identified together with a summary of current therapeutics options. Review of the literature recognises hypoglycaemia as a limiting factor for the attainment of optimal glycaemic control, primarily in children. Additional specific confounding issues include unpredictable eating and exercise patterns especially in the youngest age group. Closed-loop systems might be particularly helpful, but have to consider increased insulin sensitivity, lower insulin doses, and human factors such as size and usability of closed-loop components. CONCLUSIONS: Closed-loop systems may represent an alternative treatment option to achieve target glucose levels whilst reducing the risk of hypoglycaemia in children with T1D. SN - 1872-8227 UR - https://www.unboundmedicine.com/medline/citation/21864745/Closed_loop_in_children_with_type_1_diabetes:_specific_challenges_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-8227(11)70029-8 DB - PRIME DP - Unbound Medicine ER -