Document Detail

Frequency of morning ketosis after overnight insulin suspension using an automated nocturnal predictive low glucose suspend system.
MedLine Citation:
PMID:  24757229     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE To assess the effect of overnight insulin pump suspension in an automated predictive low glucose suspend system on morning blood glucose and ketone levels in an attempt to determine whether routine measurement of ketone levels is useful when a closed-loop system that suspends insulin delivery overnight is being used. RESEARCH DESIGN AND METHODS Data from an in-home randomized trial of 45 individuals with type 1 diabetes (age range 15-45 years) were analyzed, evaluating an automated predictive low glucose pump suspension system in which blood glucose, blood ketone, and urine ketone levels were measured on 1,954 mornings. RESULTS One or more pump suspensions occurred during 744 of the 977 intervention nights (76%). The morning blood ketone level was ≥0.6 mmol/L after 11 of the 744 nights (1.5%) during which a pump suspension occurred and 2 of the 233 nights (0.9%) during which there was no suspension compared with 11 of 977 control nights (1.1%). The morning blood ketone level was ≥0.6 mmol/L after only 2 of 159 nights (1.3%) with a pump suspension exceeding 2 h. Morning fasting blood glucose level was not a good predictor of the presence of blood ketones. CONCLUSIONS Routine measurement of blood or urine ketones during use of an automated pump suspension system using continuous glucose monitoring, whether threshold based or predictive, is not necessary. Recommendations for checking ketone levels should be no different when a patient is using a system with automated insulin suspension than it is for conventional diabetes self-management.
Roy W Beck; Dan Raghinaru; R Paul Wadwa; H Peter Chase; David M Maahs; Bruce A Buckingham;
Related Documents :
22580189 - Hypertension strengthens δ-ala-d activity inhibition and increases it reactivation ind...
2283569 - Peptic ulcer disease in youths with insulin-dependent diabetes mellitus: a prospective ...
21054539 - Diabetes mellitus in elkhounds is associated with diestrus and pregnancy.
11845229 - Impaired intellectual development in children with type i diabetes: association with hb...
22639289 - Peri-procedural tight glycemic control during early percutaneous coronary intervention ...
2102979 - Prolactin action in cystic fibrosis.
8013759 - Time course for effects of hypoglycemia on insulin gene transcription in vivo.
12364359 - Association of enos glu298asp polymorphism with end-stage renal disease.
3311679 - Moderate insulinopenia can cause insulin antagonism.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diabetes care     Volume:  37     ISSN:  1935-5548     ISO Abbreviation:  Diabetes Care     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-04-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7805975     Medline TA:  Diabetes Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1224-9     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  First use of model predictive control in outpatient wearable artificial pancreas.
Next Document:  Treatment of Recent-Onset Type 1 Diabetic Patients With DiaPep277: Results of a Double-Blind, Placeb...