Andreas Melmer, Switzerland
Inselspital, Bern University Hospital and University of Bern Department of Diabetes, Endocrinology, Nutritional Medicine and MetabolismPresenter of 1 Presentation
SIMULTANEOUS COMPARISON OF BASAL-RATE ADAPTIONS SUGGESTED BY AN OPEN-SOURCE ARTIFICIAL PANCREAS SYSTEM WITH ACTUAL BASAL-RATE DELIVERY OF AN APPROVED HYBRID CLOSED LOOP SYSTEM
Abstract
Background and Aims
Open-source artificial pancreas systems (openAPS) autonomously adapt insulin delivery in order to achieve and maintain euglycemia. OpenAPS has not been approved for human use. We compared suggested adaptions and delivery of basal-rate doses of an openAPS with actual adaptions and delivery of the Medtronic 670G closed loop system (M670G). Both systems were simultaneously active.
Methods
Seven participants using M670G completed the study. Each participant carried a separated openAPS in close distance, which was filled with saline for a maximum duraton of seven days. Both systems simultaneously received independent CGM glucose measurements (Guardian Sensor 3 for M670G and Dexcom G6 glucose sensor for openAPS).
Results
OpenAPS and M670G were simultaneously active for 546.7 hours. CGM measurements matched in 92.59%. Decision to increase or decrease current basal-rate doses were consistent in 83.87% of all time-points among both systems. OpenAPS delivered higher basal rate doses compared to M670G during daytime (from 06:00 to 23:59h; 25.31 ± 16.71 IU vs. 14.70 ± 10.92 IU; p=0.033), nighttime (from 24:00 to 5:59h; 12.08 ± 4.95 IU vs. 6.82 ± 4.51 IU; p<0.001), euglycemia (CGM-glucose 4.0-10.0 mmol/L; 29.50 ± 20.95 IU vs. 15.94± 11.49 IU; p<0.001), and hyperglycemia (CGM-glucose >10.0 mmol/L; 3.51 ± 4.26 IU vs. 1.45± 1.71 IU; p=0.002) but similar doses during hypoglycemia (CGM-glucose <4.0 mmol/L; 0.32 ± 0.41 IU vs. 0.03 ± 0.06 IU; p=0.077).
Conclusions
Decision to increase or decrease current basal rate doses were similar in openAPS and M670G. In general, openAPS delivered higher basal rate doses as compared to M670G, except during hypoglycemia.