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Review

Closed-loop insulin delivery: current status of diabetes technologies and future prospects

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Pages 579-590 | Received 01 Jun 2018, Accepted 19 Jul 2018, Published online: 30 Jul 2018

References

  • Atkinson MA, Maclaren NK. The pathogenesis of insulin-dependent diabetes mellitus. N Engl J Med. 1994;331:1428–1436.
  • International Diabetes Federation (IDF). IDF diabetes atlas. 7th ed. 2015. Available from: http://www.diabetesatlas.org/
  • Maahs DM, West NA, Lawrence JM, et al. Epidemiology of type 1 diabetes. Endocrinol Metab Clin North Am. 2010;39:481–497.
  • Teff KL, Mattes RD, Engelman K. Cephalic phase insulin release in normal weight males: verification and reliability. Am J Physiol Endocrinol Metab. 1991;261:430–436.
  • Yeh H-C, Brown TT, Maruthur N, et al. Comparative effectiveness and safety of methods of insulin delivery and glucose monitoring for diabetes mellitus: a systematic review and meta-analysis. Ann Intern Med. 2012;157:336–347.
  • Misra S. Diabetic ketoacidosis in adults. BMJ. 2015;5660:1–8.
  • Group TDC and CTR. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–986.
  • Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Study Research Group. Intensive Diabetes Treatment and Cardiovascular Outcomes in type 1 diabetes: the DCCT/EDIC Study 30-Year Follow-up. Diabetes Care. 2016;39:686–693.
  • Thabit H, Hovorka R. Coming of age: the artificial pancreas for type 1 diabetes. Diabetologia. 2016;59:1795–1805.
  • Kropff J, DeVries JH. Continuous glucose monitoring, future products, and update on worldwide artificial pancreas projects. Diabetes Technol Ther. 2016;18:53–63.
  • Atkinson MA, Eisenbarth GS, Michels AW. Type 1 diabetes. Lancet. 2014;383:69–82.
  • NICE. Type 1 diabetes in adults: diagnosis and management. NICE (NG17). 2015;1–87.
  • Little S, Shaw J, Home P. Hypoglycemia rates with basal insulin analogs. Diabetes Technol Ther. 2011;13:53–64.
  • Lane W, Bailey TS, Gerety G, et al. Effect of insulin degludec vs insulin glargine U100 on hypoglycemia in patients with type 1 diabetes. JAMA. 2017;318:33.
  • Lane W, Bailey TS, Gerety G, et al. SWITCH 1: reduced risk of hypoglycaemia with insulin degludec vs insulin glargine U100 in patients with type 1 diabetes: a randomised, double-blind, crossover trial. Diabetologia. 2016;59:42–43.
  • Bradley C, Eschwège E, de Pablos-Velasco P, et al. Predictors of quality of life and other patient-reported outcomes in the PANORAMA multinational study of people with type 2 diabetes. Diabetes Care. 2018;41:267–276.
  • Thabit H, Hovorka R. Continuous subcutaneous insulin infusion therapy and multiple daily insulin injections in type 1 diabetes mellitus: a comparative overview and future horizons. Expert Opin Drug Deliv. 2015;5247:1–12.
  • Lenhard MJ, Reeves GD. Continuous subcutaneous insulin infusion: a comprehensive review of insulin pump therapy. Arch Intern Med. 2001;161:2293–2300.
  • Nathan DM, Cleary PA, Backlund J-YC, et al. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 2005;353:2643–2653.
  • Zisser HC. The Omnipod insulin management system: the latest innovation in insulin pump therapy. Diabetes Ther. 2010;1:10–24.
  • Driscoll KA, Johnson SB, Hogan J, et al. Insulin bolusing software: the potential to optimize health outcomes in type 1 diabetes mellitus. J Diabetes Sci Technol. 2013;7:646–652.
  • Bally L, Thabit H, Hovorka R. Finding the right route for insulin delivery – an overview of implantable pump therapy. Expert Opin Drug Deliv. 2017;14:1103–1111.
  • Renard E. Insulin delivery route for the artificial pancreas: subcutaneous, intraperitoneal, or intravenous? Pros and cons. J Diabetes Sci Technol. 2008;2:735–738.
  • Renard E, Schaepelynck-Bélicar P. Implantable insulin pumps. A position statement about their clinical use. Diabetes Metab. 2007;33:158–166.
  • Pickup JC, Sutton AJ. Severe hypoglycaemia and glycaemic control in Type 1 diabetes: meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion. Diabetic Med. 2008;25:765–774.
  • Jeitler K, Horvath K, Berghold A, et al. Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with diabetes mellitus: systematic review and meta-analysis. Diabetologia. 2008;51:941–951.
  • Misso ML, Egberts KJ, Page M, et al. Continuous subcutaneous insulin infusion (CSII) versus multiple insulin injections for type 1 diabetes mellitus. Cochrane Database Syst Rev. 2010;1:CD005103.
  • Zabeen B, Craig ME, Virk SA, et al. Insulin pump therapy is associated with lower rates of retinopathy and peripheral nerve abnormality. PLoS ONE. 2016;11:1–10.
  • Steineck I, Cederholm J, Eliasson B, et al. Insulin pump therapy, multiple daily injections, and cardiovascular mortality in 18 168 people with type 1 diabetes: observational study. BMJ. 2015;350:3234.
  • Barnard KD, Lloyd CE, Skinner TC. Systematic literature review: quality of life associated with insulin pump use in type 1 diabetes. Diabet Med. 2007;24:607–617.
  • Danne T, Battelino T, Jarosz-Chobot P, et al. Establishing glycaemic control with continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes: experience of the pedpump study in 17 countries. Diabetologia. 2008;51:1594–1601.
  • Phillip M, Battelino T, Rodriguez H, et al. Use of insulin pump therapy in the pediatric age-group. Diabetes Care. 2007;30:1653–1662.
  • Olansky L, Kennedy L. Finger-stick glucose monitoring: issues of accuracy and specificity. Diabetes Care. 2010;33:948–949.
  • Klonoff DC. Benefits and limitations of self-monitoring of blood glucose. J Diabetes Sci Technol. 2007;1:130–132.
  • Acciaroli G, Vettoretti M, Facchinetti A, et al. Calibration of minimally invasive continuous glucose monitoring sensors: state-of-the-art and current perspectives. Biosensors. 2018;8:1–17.
  • Matuleviciene V, Joseph JI, Andelin M, et al. A clinical trial of the accuracy and treatment experience of the Dexcom G4 sensor (Dexcom G4 System) and Enlite sensor (Guardian REAL-Time System) tested simultaneously in ambulatory patients with type 1 diabetes. Diabetes Technol Ther. 2014;16:759–767.
  • Liebl A, Henrichs HR, Heinemann L, et al. Continuous glucose monitoring: evidence and consensus statement for clinical use. J Diabetes Sci Technol. 2013;7:500–519.
  • Battelino T, Phillip M, Bratina N, et al. Effect of continuous glucose monitoring on hypoglycemia in type 1 diabetes. Diabetes Care. 2011;34:795–800.
  • Martín-Timón I. Mechanisms of hypoglycemia unawareness and implications in diabetic patients. World J Diabetes. 2015;6:912.
  • Lawton J, Blackburn M, Allen J, et al. Patients’ and caregivers’ experiences of using continuous glucose monitoring to support diabetes self-management: qualitative study. BMC Endocr Disord. 2018;18:1–10.
  • Deiss D, Bolinder J, Riveline JP, et al. Improved glycemic control in poorly controlled patients with type 1 diabetes using real-time continuous glucose monitoring. Diabetes Care. 2006;29:2730–2732.
  • Battelino T, Conget I, Olsen B, et al. The use and efficacy of continuous glucose monitoring in type 1 diabetes treated with insulin pump therapy: a randomised controlled trial. Diabetologia. 2012;55:3155–3162.
  • Beck RW, Riddlesworth T, Ruedy K, et al. Effect of continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections. JAMA. 2017;317:371.
  • Lind M, Polonsky W, Hirsch IB, et al. Continuous glucose monitoring vs conventional therapy for glycemic control in adults with type 1 diabetes treated with multiple daily insulin injections. JAMA. 2017;317:379.
  • Charleer S, Mathieu C, Nobels F, et al. Effect of continuous glucose monitoring on glycemic control, acute admissions, and quality of life: a real-world study. J Clin Endocrinol Metab. 2018;103:1224–1232.
  • Wan W, Skandari MR, Minc A, et al. Cost-effectiveness of continuous glucose monitoring for adults with type 1 diabetes compared with self-monitoring of blood glucose: the DIAMOND randomized trial. Diabetes Care. 2018;41:1227–1234.
  • Jendle J, Smith-Palmer J, Delbaere A, et al. Cost-effectiveness analysis of sensor-augmented insulin pump therapy with automated insulin suspension versus standard insulin pump therapy in patients with type 1 diabetes in Sweden. Diabetes Ther. 2017;8:1015–1030.
  • Danne T, Nimri R, Battelino T, et al. International consensus on use of continuous glucose monitoring. Diabetes Care. 2017;40:1631–1640.
  • Bailey T, Bode BW, Christiansen MP, et al. The performance and usability of a factory-calibrated flash glucose monitoring system. Diabetes Technol Ther. 2015;17:787–794.
  • Hoss U, Budiman ES. Factory-calibrated continuous glucose sensors: the science behind the technology. Diabetes Technol Ther. 2017;19:44–50.
  • Ólafsdóttir AF, Attvall S, Sandgren U, et al. A clinical trial of the accuracy and treatment experience of the flash glucose monitor freestyle libre in adults with type 1 diabetes. Diabetes Technol Ther. 2017;19:164–172.
  • Thabit H, Bally L, Hovorka R. Available at a flash: a new way to check glucose. Lancet. 2016;388:2213–2214.
  • FDA News. Senseonics’ Eversense Recommended for Approval by FDA | 2018-04-03| FDANews. FDANEWS; 2018. Available from: https://www.fdanews.com/articles/186250-senseonics-eversense-recommended-for-approval-by-fda.
  • Mortellaro M, DeHennis A. Performance characterization of an abiotic and fluorescent-based continuous glucose monitoring system in patients with type 1 diabetes. Biosens Bioelectron. 2014;61:227–231.
  • Christiansen MP, Klaff LJ, Brazg R, et al. A prospective multicenter evaluation of the accuracy of a novel implanted continuous glucose sensor: PRECISE II. Diabetes Technol Ther. 2018;20:197–206.
  • Bergenstal RM, Tamborlane WV, Ahmann A, et al. Effectiveness of sensor-augmented insulin-pump therapy in type 1 diabetes. N Engl J Med. 2010;363:311–320.
  • Raccah D, Sulmont V, Reznik Y, et al. Incremental value of continuous glucose monitoring when starting pump therapy in patients with poorly controlled type 1 diabetes: the real trend study. Diabetes Care. 2009;32:2245–2250.
  • Bergenstal RM, Klonoff DC, Garg SK, et al. Threshold-based insulin-pump interruption for reduction of hypoglycemia. N Engl J Med. 2013;369:224–232.
  • Battelino T, Nimri R, Dovc K, et al. Prevention of hypoglycemia with predictive low glucose insulin suspension in children with type 1 diabetes: a randomized controlled trial. Diabetes Care. 2017;40:764–770.
  • Abraham MB, Nicholas JA, Smith GJ, et al. Reduction in hypoglycemia with the predictive low-Glucose management system: a long-term randomized controlled trial in adolescents with type 1 diabetes. Diabetes Care. 2018;41:303–310.
  • Business Wire. Tandem Diabetes Care Announces FDA Approval of t : slim X2 Insulin Pump with Basal-IQ Technology.[2018.6.21] Business Wire. 2018. Available from: https://www.businesswire.com/news/home/20180621006260/en/Tandem-Diabetes-Care-Announces-FDA-Approval-tslim.
  • Steil GM, Rebrin K, Darwin C, et al. Feasibility of automating insulin delivery for the treatment of type 1 diabetes. Diabetes. 2006;55:3344–3350.
  • Hovorka R, Canonico V, Chassin LJ, et al. Nonlinear model predictive control of glucose concentration in subjects with type 1 diabetes. Physiol Meas. 2004;25:905–920.
  • Phillip M, Battelino T, Atlas E, et al. Nocturnal glucose control with an artificial pancreas at a diabetes camp. N Engl J Med. 2013;368:824–833.
  • Herrero P, Georgiou P, Oliver N, et al. A bio-inspired glucose controller based on pancreatic β-cell physiology. J Diabetes Sci Technol. 2012;6:606–616.
  • Home PD. The pharmacokinetics and pharmacodynamics of rapid-acting insulin analogues and their clinical consequences. Diabetes, Obes and Metabol. 2012;14:780–788.
  • Heise T, Hövelmann U, Brøndsted L, et al. Faster-acting insulin aspart: earlier onset of appearance and greater early pharmacokinetic and pharmacodynamic effects than insulin aspart. Diabetes Obes Metab. 2015;17:682–688.
  • Riddell MC, Zaharieva DP, Yavelberg L, et al. Exercise and the development of the artificial pancreas: one of the more difficult series of hurdles. J Diabetes Sci Technol. 2015;9:1217–1226.
  • Bally L, Thabit H, Kojzar H, et al. Day-and-night glycaemic control with closed-loop insulin delivery versus conventional insulin pump therapy in free-living adults with well controlled type 1 diabetes: an open-label, randomised, crossover study. Lancet Diabetes Endocrinol. 2017;5:261–270.
  • Ly TT, Buckingham BA, DeSalvo DJ, et al. Day-and-night closed-loop control using the unified safety system in adolescents with type 1 diabetes at camp. Diabetes Care. 2016;39:106–107.
  • Del Favero S, Boscari F, Messori M, et al. Randomized summer camp crossover trial in 5-to 9-year-old children: outpatient wearable artificial pancreas is feasible and safe. Diabetes Care. 2016;39:1180–1185.
  • Thabit H, Tauschmann M, Allen JM, et al. Home use of an artificial beta cell in type 1 diabetes. N Engl J Med. 2015;373:2129–2140.
  • Cryer PE. Minireview: glucagon in the pathogenesis of hypoglycemia and hyperglycemia in diabetes. Endocrinology. 2012;153:1039–1048.
  • El-Khatib FH, Balliro C, Hillard MA, et al. Home use of a bihormonal bionic pancreas versus insulin pump therapy in adults with type 1 diabetes : a multicentre randomised crossover trial. Lancet. 2016;6736:369–380.
  • Haidar A, Messier V, Legault L, et al. Outpatient 60-hour day-and-night glucose control with dual-hormone artificial pancreas, single-hormone artificial pancreas, or sensor-augmented pump therapy in adults with type 1 diabetes: an open-label, randomised, crossover, controlled trial. Diabetes, Obes Metab. 2017;19:713–720.
  • Russell SJ, El-Khatib FH, Sinha M, et al. Outpatient glycemic control with a bionic pancreas in type 1 diabetes. N Engl J Med. 2014;371:313–325.
  • Russell SJ, Hillard MA, Balliro C, et al. Day and night glycaemic control with a bionic pancreas versus conventional insulin pump therapy in preadolescent children with type 1 diabetes: a randomised crossover trial. Lancet Diabetes Endocrinol. 2016;4:233–243.
  • Bekiari E, Kitsios K, Thabit H, et al. Artificial pancreas treatment for outpatients with type 1 diabetes: systematic review and meta-analysis. BMJ. 2018;361:k1310.
  • Weisman A, Bai J-W, Cardinez M, et al. Effect of artificial pancreas systems on glycaemic control in patients with type 1 diabetes: a systematic review and meta-analysis of outpatient randomised controlled trials. Lancet Diabetes Endocrinol. 2017;5:501–512.
  • Peters TM, Haidar A. Dual-hormone artificial pancreas: benefits and limitations compared with single-hormone systems. Diabetic Med. 2018;35:450–459.
  • Taleb N, Haidar A, Messier V, et al. Glucagon in artificial pancreas systems: potential benefits and safety profile of future chronic use. Diabetes, Obes and Metabol. 2017;19:13–23.
  • Caputo N, Castle JR, Bergstrom CP, et al. Mechanisms of glucagon degradation at alkaline pH. Peptides. 2013;45:40–47.
  • Rylander D. Glucagon in the artificial pancreas: supply and marketing challenges. J Diabetes Sci Technol. 2015;9:52–55.
  • Lebovitz HE. Adjunct therapy for type 1 diabetes mellitus. Nat Rev Endocrinol. 2010;6:326–334.
  • Ramkissoon CM, Aufderheide B, Bequette BW, et al. A model of glucose-insulin-pramlintide pharmacokinetics and pharmacodynamics in type 1 diabetes. J Diabetes Sci Technol. 2014;8:529–542.
  • Hinshaw L, Schiavon M, Dadlani V, et al. Effect of pramlintide on postprandial glucose fluxes in type 1 diabetes. J Clin Endocrinol Metab. 2016;101:1954–1962.
  • Weinzimer SA, Sherr JL, Cengiz E, et al. Effect of pramlintide on prandial glycemic excursions during closed-loop control in adolescents and young adults with type 1 diabetes. Diabetes Care. 2012;35:1994–1999.
  • Qiao Y-C, Ling W, Pan Y-H, et al. Efficacy and safety of pramlintide injection adjunct to insulin therapy in patients with type 1 diabetes mellitus: a systematic review and meta-analysis. Oncotarget. 2017;8:66504–66515.
  • Barnard KD, Wysocki T, Ully V, et al. Closing the loop in adults, children and adolescents with suboptimally controlled type 1 diabetes under free living conditions: a psychosocial substudy. J Diabetes Sci Technol. 2017;11:1080–1088.
  • Ziegler C, Liberman A, Nimri R, et al. Reduced worries of hypoglycaemia, high satisfaction, and increased perceived ease of use after experiencing four nights of MD-logic artificial pancreas at home (DREAM4). J Diabetes Res. 2015;2015:590308.
  • Kitzmiller JL, Block JM, Brown FM, et al. Managing preexisting diabetes for pregnancy: summary of evidence and consensus recommendations for care. Diabetes Care. 2008;31:1060–1079.
  • Casson IF, Clarke CA, Howard CV, et al. Outcomes of pregnancy in insulin dependent diabetic women: results of a five year population cohort study. BMJ. 1997;315(7103):275–278.
  • Murphy HR, Elleri D, Allen JM, et al. Pathophysiology of postprandial hyperglycaemia in women with type 1 diabetes during pregnancy. Diabetologia. 2012;55:282–293.
  • Stewart ZA, Wilinska ME, Hartnell S, et al. Closed-loop insulin delivery during pregnancy in women with type 1 diabetes. N Engl J Med. 2016;375:644–654.
  • Stewart ZA, Wilinska ME, Hartnell S, et al. Day-and-night closed-loop insulin delivery in a broad population of pregnant women with type 1 diabetes: a randomized controlled crossover trial. Diabetes Care. 2018;41:1391–1399.
  • Dhatariya K. Should inpatient hyperglycaemia be treated? BMJ. 2013;346:f134.
  • Umpierrez GE, Isaacs SD, Bazargan N, et al. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab. 2002;87:978–982.
  • Health and Social Care Information Centre (HSCIC) NHS UK. National diabetes inpatient audit. 2016. [cited 24 Apr 2018]. Available from: http://www.ic.nhs.uk/diabetesinpatientaudit.
  • Wexler DJ, Meigs JB, Cagliero E, et al. Prevalence of hyper- and hypoglycemia among inpatients with diabetes: a national survey of 44 U.S. Hospitals Diabetes Care. 2007;30:367–369.
  • Societies JBD. The use of variable rate intravenous insulin infusion (VRIII) in medical inpatients. 2014;(October).
  • Schnipper JL, Barsky EE, Shaykevich S, et al. Inpatient management of diabetes and hyperglycemia among general medicine patients at a large teaching hospital. J Hosp Med. 2006;1:145–150.
  • Baldwin D, Villanueva G, McNutt R, et al. Eliminating inpatient sliding-scale insulin: a reeducation project with medical house staff. Diabetes Care. 2005;28:1008–1011.
  • Thabit H, Hartnell S, Allen JM, et al. Closed-loop insulin delivery in inpatients with type 2 diabetes: a randomised, parallel-group trial. Lancet Diabetes Endocrinol. 2017;5:117–124.
  • Bally L, Thabit H, Hartnell S, et al. Closed-loop insulin delivery for glycemic control in noncritical care. N Engl J Med. 2018;NEJMoa1805233.
  • Riddell MC, Gallen IW, Smart CE, et al. Exercise management in type 1 diabetes: a consensus statement. Lancet Diabetes Endocrinol. 2017;5:377–390.
  • Bally L, Thabit H. Closing the loop on exercise in type 1 diabetes. Curr Diabetes Rev. 2017;14:257–265.
  • Taleb N, Emami A, Suppere C, et al. Efficacy of single-hormone and dual-hormone artificial pancreas during continuous and interval exercise in adult patients with type 1 diabetes: randomised controlled crossover trial. Diabetologia. 2016;59:2561–2571.
  • Sherr JL, Cengiz E, Palerm CC, et al. Reduced hypoglycemia and increased time in target using closed-loop insulin delivery during nights with or without antecedent afternoon exercise in type 1 diabetes. Diabetes Care. 2013;36:2909–2914.
  • Dovc K, Macedoni M, Bratina N, et al. Closed-loop glucose control in young people with type 1 diabetes during and after unannounced physical activity: a randomised controlled crossover trial. Diabetologia. 2017;60:2157–2167.
  • Bergenstal RM, Garg S, Weinzimer SA, et al. Safety of a hybrid closed-loop insulin delivery system in patients with type 1 diabetes. JAMA. 2016;316:1407.
  • Garg SK, Weinzimer SA, Tamborlane WV, et al. Glucose outcomes with the in-home use of a hybrid closed-loop insulin delivery system in adolescents and adults with type 1 diabetes. Diabetes Technol Ther. 2017;19:155–163.
  • Buckingham BA, Forlenza GP, Pinsker JE, et al. Safety and feasibility of the Omnipod hybrid closed-loop system in adult, adolescent, and pediatric patients with type 1 diabetes using a personalized model predictive control algorithm. Diabetes Technol Ther. 2018;20:257–262.
  • El-Khatib FH, Balliro C, Hillard MA, et al. Home use of a bihormonal bionic pancreas versus insulin pump therapy in adults with type 1 diabetes: a multicentre randomised crossover trial. Lancet. 2017;389:369–380.
  • Lee JM, Newman MW, Gebremariam A, et al. Real-world use and self-reported health outcomes of a patient-designed do-it-yourself mobile technology system for diabetes: lessons for mobile health. Diabetes Technol Ther. 2017;19:209–219.
  • Lewis D, Leibrand S. Real-world use of open source artificial pancreas systems. J Diabetes Sci Technol. 2016;10:1411.
  • Bally L, Thabit H, Hovorka R. Closed-loop for type 1 diabetes - an introduction and appraisal for the generalist. BMC Med. 2017;15:14.
  • Bally L, Thabit H, Ruan Y, et al. Bolusing frequency and amount impacts glucose control during hybrid closed-loop. Diabet Med. 2018;35:347–351.
  • Breton MD, Cherñavvsky DR, Forlenza GP, et al. Closed-loop control during intense prolonged outdoor exercise in adolescents with type 1 diabetes: the artificial pancreas ski study. Diabetes Care. 2017;40:1644–1650.
  • Cherñavvsky DR, De Boer MD, Keith-Hynes P, et al. Use of an artificial pancreas among adolescents for a missed snack bolus and an underestimated meal bolus. Pediatr Diabetes. 2016;17:28–35.
  • De Boer MD, Breton MD, Wakeman C, et al. Performance of an artificial pancreas system for young children with type 1 diabetes. Diabetes Technol Ther. 2017;19:293–298.
  • Forlenza GP, Deshpande S, Ly TT, et al. Application of zone model predictive control artificial pancreas during extended use of infusion set and sensor: a randomized crossover-controlled home-use trial. Diabetes Care. 2017;40:1096–1102.
  • Kovatchev BP, Renard E, Cobelli C, et al. Safety of outpatient closed-loop control: first randomized crossover trials of a wearable artificial pancreas. Diabetes Care. 2014;37:1789–1796.
  • Leelarathna L, Dellweg S, Mader JK, et al. Day and night home closed-loop insulin delivery in adults with type 1 diabetes: three-center randomized crossover study. Diabetes Care. 2014;37:1931–1937.
  • Ly TT, Roy A, Grosman B, et al. Day and night closed-loop control using the integrated Medtronic hybrid closed-loop system in type 1 diabetes at diabetes camp. Diabetes Care. 2015;38:1205–1211.
  • Tauschmann M, Allen JM, Wilinska ME, et al. Day-and-night hybrid closed-loop insulin delivery in adolescents with type 1 diabetes: a free-living, randomized clinical trial. Diabetes Care. 2016;39:1168–1174.
  • Tauschmann M, Allen JM, Wilinska ME, et al. Home use of day-and-night hybrid closed-loop insulin delivery in suboptimally controlled adolescents with type 1 diabetes: a 3-week, free-living, randomized crossover trial. Diabetes Care. 2016;39:2019–2025.

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