Predictors of Hypoglycemia in the ASPIRE In-Home Study and Effects of Automatic Suspension of Insulin Delivery

Background: Hypoglycemia varies between patients with type 1 diabetes and is the main obstacle to therapy intensification. We investigated known and potential risk factors for hypoglycemia in subjects with type 1 diabetes. Method: In the ASPIRE In-Home study (NCT01497938), a randomized trial of the...

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Published in:Journal of diabetes science and technology 2015-05, Vol.9 (5), p.1016-1020
Main Authors: Weiss, Ram, Garg, Satish K., Bergenstal, Richard M., Klonoff, David C., Bode, Bruce W., Bailey, Timothy S., Thrasher, James, Schwartz, Frank, Welsh, John B., Kaufman, Francine R., Brazg, R., Casaubon, L., Horowitz, B., Liljenquist, D., Odugbesan, O., Bhargava, A., Goland, R., Weinstock, R.
Format: Article
Language:English
Subjects:
Blood Glucose - analysis
Blood Glucose Self-Monitoring
Diabetes Mellitus, Type 1 - blood
Diabetes Mellitus, Type 1 - drug therapy
Female
Humans
Hypoglycemia - blood
Hypoglycemia - chemically induced
Hypoglycemic Agents - administration & dosage
Hypoglycemic Agents - adverse effects
Hypoglycemic Agents - therapeutic use
Insulin - administration & dosage
Insulin - adverse effects
Insulin - therapeutic use
Insulin Infusion Systems
Male
Original
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Summary:Background: Hypoglycemia varies between patients with type 1 diabetes and is the main obstacle to therapy intensification. We investigated known and potential risk factors for hypoglycemia in subjects with type 1 diabetes. Method: In the ASPIRE In-Home study (NCT01497938), a randomized trial of the threshold suspend (TS) feature of sensor-augmented insulin pump (SAP) therapy, subjects’ propensity to nocturnal hypoglycemia (NH) was established in a 2-week run-in phase and assessed in a 3-month study phase via continuous glucose monitoring. Categorical variables were tested for association with NH rates in both phases. Results: Elevated rates of NH were significantly associated with baseline A1C ≤7%, with bolus insulin deliveries unassisted by the bolus estimation calculator, and with assignment to the control group during the study phase. Conclusions: Routine use of the TS feature and the bolus estimation calculator are strategies that may reduce the risk of NH.
ISSN:1932-2968
1932-2968
1932-3107
DOI:10.1177/1932296815586014