226 results on '"Boughton, Charlotte K"'
Search Results
2. Fully automated closed-loop insulin delivery in adults with type 2 diabetes: an open-label, single-center, randomized crossover trial
- Author
-
Daly, Aideen B., Boughton, Charlotte K., Nwokolo, Munachiso, Hartnell, Sara, Wilinska, Malgorzata E., Cezar, Alina, Evans, Mark L., and Hovorka, Roman
- Published
- 2023
- Full Text
- View/download PDF
3. The effect of closed-loop glucose control on C-peptide secretion in youth with newly diagnosed type 1 diabetes: the CLOuD RCT
- Author
-
Boughton, Charlotte K, primary, Allen, Janet M, additional, Ware, Julia, additional, Wilinska, Malgorzata E, additional, Hartnell, Sara, additional, Thankamony, Ajay, additional, Randell, Tabitha, additional, Ghatak, Atrayee, additional, Besser, Rachel EJ, additional, Elleri, Daniela, additional, Trevelyan, Nicola, additional, Campbell, Fiona M, additional, Rankin, David, additional, Kimbell, Barbara, additional, Lawton, Julia, additional, Sibayan, Judy, additional, Calhoun, Peter, additional, Bailey, Ryan, additional, Dunseath, Gareth, additional, and Hovorka, Roman, additional
- Published
- 2024
- Full Text
- View/download PDF
4. Parents’ experiences of using a hybrid closed-loop system (CamAPS FX) to care for a very young child with type 1 diabetes: Qualitative study
- Author
-
Kimbell, Barbara, Rankin, David, Hart, Ruth I., Allen, Janet M., Boughton, Charlotte K., Campbell, Fiona, Fröhlich-Reiterer, Elke, Hofer, Sabine E., Kapellen, Thomas M., Rami-Merhar, Birgit, Schierloh, Ulrike, Thankamony, Ajay, Ware, Julia, Hovorka, Roman, and Lawton, Julia
- Published
- 2022
- Full Text
- View/download PDF
5. Cambridge hybrid closed-loop algorithm in children and adolescents with type 1 diabetes: a multicentre 6-month randomised controlled trial
- Author
-
Hovorka, R, Acerini, C L, Thankamony, A, Allen, J M, Boughton, C K, Dovc, K, Dunger, D B, Ware, J, Musolino, G, Tauschmann, M, Wilinska, M E, Hayes, J F, Hartnell, S, Slegtenhorst, S, Ruan, Y, Haydock, M, Mangat, J, Denvir, L, Kanthagnany, SK, Law, J, Randell, T, Sachdev, P, Saxton, M, Coupe, A, Stafford, S, Ball, A, Keeton, R, Cresswell, R, Crate, L, Cripps, H, Fazackerley, H, Looby, L, Navarra, H, Saddington, C, Smith, V, Verhoeven, V, Bratt, S, Khan, N, Moyes, L, Sandhu, K, West, C, Wadwa, R P, Alonso, G, Forlenza, G, Slover, R, Towers, L, Berget, C, Coakley, A, Escobar, E, Jost, E, Lange, S, Messer, L, Thivener, K, Campbell, F M, Yong, J, Metcalfe, E, Allen, M, Ambler, S, Waheed, S, Exall, J, Tulip, J, Buckingham, B A, Ekhlaspour, L, Maahs, D, Norlander, L, Jacobson, T, Twon, M, Weir, C, Leverenz, B, Keller, J, Davis, N, Kumaran, A, Trevelyan, N, Dewar, H, Price, G, Crouch, G, Ensom, R, Haskell, L, Lueddeke, LM, Mauras, N, Benson, M, Bird, K, Englert, K, Permuy, J, Ponthieux, K, Marrero-Hernandez, J, DiMeglio, L A, Ismail, H, Jolivette, H, Sanchez, J, Woerner, S, Kirchner, M, Mullen, M, Tebbe, M, Besser, R EJ, Basu, S, London, R, Makaya, T, Ryan, F, Megson, C, Bowen-Morris, J, Haest, J, Law, R, Stamford, I, Ghatak, A, Deakin, M, Phelan, K, Thornborough, K, Shakeshaft, J, Weinzimer, S A, Cengiz, E, Sherr, J L, Van Name, M, Weyman, K, Carria, L, Steffen, A, Zgorski, M, Sibayan, J, Beck, R W, Borgman, S, Davis, J, Rusnak, J, Hellman, A, Cheng, P, Kanapka, L, Kollman, C, McCarthy, C, Chalasani, S, Hood, K K, Hanes, S, Viana, J, Lanning, M, Fox, D S, Arreaza-Rubin, G, Eggerman, T, Green, N, Janicek, R, Gabrielson, D, Belle, S H, Castle, J, Green, J, Legault, L, Willi, S M, Wysham, C, Ware, Julia, Boughton, Charlotte K, Allen, Janet M, Wilinska, Malgorzata E, Tauschmann, Martin, Denvir, Louise, Thankamony, Ajay, Campbell, Fiona M, Wadwa, R Paul, Buckingham, Bruce A, Davis, Nikki, DiMeglio, Linda A, Mauras, Nelly, Besser, Rachel E J, Ghatak, Atrayee, Weinzimer, Stuart A, Hood, Korey K, Fox, D Steven, Kanapka, Lauren, Kollman, Craig, Sibayan, Judy, Beck, Roy W, and Hovorka, Roman
- Published
- 2022
- Full Text
- View/download PDF
6. Effect of 48 Months of Closed-Loop Insulin Delivery on Residual C-Peptide Secretion and Glycemic Control in Newly Diagnosed Youth With Type 1 Diabetes: A Randomized Trial.
- Author
-
Ware, Julia, Boughton, Charlotte K., Allen, Janet M., Wilinska, Malgorzata E., Hartnell, Sara, Thankamony, Ajay, Randell, Tabitha, Ghatak, Atrayee, Besser, Rachel E.J., Elleri, Daniela, Trevelyan, Nicola, Campbell, Fiona M., Sibayan, Judy, Bailey, Ryan, Calhoun, Peter, Dunseath, Gareth, Hovorka, Roman, Verhoeven, Vreni, Thankmonay, Ajay, and Acerini, Carlo
- Subjects
- *
TYPE 1 diabetes , *GLYCEMIC control , *HYPERGLYCEMIA , *SECRETION , *C-peptide , *INSULIN , *CANAGLIFLOZIN , *INSULIN aspart - Abstract
OBJECTIVE: We evaluated the effect of long-term intensive metabolic control with hybrid closed-loop (CL) on residual C-peptide secretion and glucose control compared with standard insulin therapy in youth with type 1 diabetes over 48 months. RESEARCH DESIGN AND METHODS: Following the 24-month primary phase of a multicenter, randomized, parallel trial of 96 newly diagnosed youth aged 10 to 16.9 years, participants were invited to an extension phase using treatment allocated at randomization. They continued with hybrid CL using the Cambridge algorithm or standard insulin therapy (control) until 48 months after diagnosis. Analysis was by intention-to-treat. RESULTS: At 24 months after diagnosis, 81 participants (mean ± SD age 14 ± 2 years) continued in the extension phase (47 CL, 34 control). There was no difference in fasting C-peptide corrected for fasting glucose at 48 months between groups (CL: 5 ± 9 vs. control: 6 ± 14 pmol/L per mmol/L; mean adjusted difference −2 [95% CI −7, 4; P = 0.54]). Central laboratory HbA1c remained lower in the CL group by 0.9% (10 mmol/mol [95% CI 0.2, 1.5; 3, 17 mmol/mol); P = 0.009). Time in target range of 3.9 to 10.0 mmol/L was 12 percentage points (95% CI 3, 20; P = 0.008) higher in the CL group compared with control. There were 11 severe hypoglycemic events (6 CL, 5 control) and 7 diabetic ketoacidosis events (3 CL, 4 control) during the extension phase. CONCLUSIONS: Improved glycemic control was sustained over 48 months after diagnosis with CL insulin delivery compared with standard therapy in youth with type 1 diabetes. This did not appear to confer a protective effect on residual C-peptide secretion. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
7. Hypoglycemia and Hyperglycemia According to Type of Diabetes: Observations During Fully Closed-Loop Insulin Delivery in Adults With Type 1 and Type 2 Diabetes
- Author
-
Kadiyala, Nithya, primary, Wilinska, Malgorzata E., additional, Daly, Aideen B., additional, Nwokolo, Munachiso, additional, Lakshman, Rama, additional, Hartnell, Sara, additional, Ware, Julia, additional, Allen, Janet M., additional, Cezar, Alina, additional, Evans, Mark L., additional, Hovorka, Roman, additional, and Boughton, Charlotte K., additional
- Published
- 2024
- Full Text
- View/download PDF
8. Contrasting glycemic outcomes in young people with diabetic ketoacidosis at onset of type 1 diabetes
- Author
-
Lakshman, Rama, primary, Najami, Mazin, additional, Hovorka, Roman, additional, and Boughton, Charlotte K, additional
- Published
- 2024
- Full Text
- View/download PDF
9. Lived Experience of Fully Closed-Loop Insulin Delivery in Adults with Type 1 Diabetes
- Author
-
Lakshman, Rama, primary, Hartnell, Sara, additional, Ware, Julia, additional, Allen, Janet M., additional, Wilinska, Malgorzata E., additional, Nwokolo, Munachiso, additional, Evans, Mark L., additional, Hovorka, Roman, additional, and Boughton, Charlotte K., additional
- Published
- 2024
- Full Text
- View/download PDF
10. Cost-Effectiveness of Closed-Loop Automated Insulin Delivery Using the Cambridge Hybrid Algorithm in Children and Adolescents with Type 1 Diabetes: Results from a Multicenter 6-Month Randomized Trial
- Author
-
Fox, D. Steven, primary, Ware, Julia, additional, Boughton, Charlotte K, additional, Allen, Janet M., additional, Wilinska, Malgorzata E, additional, Tauschmann, Martin, additional, Denvir, Louise, additional, Thankamony, Ajay, additional, Campbell, Fiona, additional, Wadwa, R. Paul, additional, Buckingham, Bruce A., additional, Davis, Nikki, additional, DiMeglio, Linda A., additional, Mauras, Nelly, additional, Besser, Rachel E. J., additional, Ghatak, Atrayee, additional, Weinzimer, Stuart A., additional, Kanapka, Lauren, additional, Kollman, Craig, additional, Sibayan, Judy, additional, Beck, Roy W., additional, Hood, Korey K., additional, and Hovorka, Roman, additional
- Published
- 2024
- Full Text
- View/download PDF
11. Postprandial Glucose Excursions with Ultra-Rapid Insulin Analogs in Hybrid Closed-Loop Therapy for Adults with Type 1 Diabetes
- Author
-
Haliloglu, Belma, primary, Boughton, Charlotte K., additional, Lakshman, Rama, additional, Ware, Julia, additional, Nwokolo, Munachiso, additional, Thabit, Hood, additional, Mader, Julia K., additional, Bally, Lia, additional, Leelarathna, Lalantha, additional, Wilinska, Malgorzata E., additional, Allen, Janet M., additional, Hartnell, Sara, additional, Evans, Mark L., additional, and Hovorka, Roman, additional
- Published
- 2024
- Full Text
- View/download PDF
12. Fully automated closed-loop glucose control compared with standard insulin therapy in adults with type 2 diabetes requiring dialysis: an open-label, randomized crossover trial
- Author
-
Boughton, Charlotte K., Tripyla, Afroditi, Hartnell, Sara, Daly, Aideen, Herzig, David, Wilinska, Malgorzata E., and Czerlau, Cecilia
- Subjects
Insulin -- Dosage and administration -- Testing ,Blood sugar -- Control ,Type 2 diabetes -- Diagnosis -- Care and treatment ,Biological sciences ,Health - Abstract
We evaluated the safety and efficacy of fully closed-loop insulin therapy compared with standard insulin therapy in adults with type 2 diabetes requiring dialysis. In an open-label, multinational, two-center, randomized crossover trial, 26 adults with type 2 diabetes requiring dialysis (17 men, 9 women, average age 68 [plus or minus] 11 years (mean [plus or minus] s.d.), diabetes duration of 20 [plus or minus] 10 years) underwent two 20-day periods of unrestricted living, comparing the Cambridge fully closed-loop system using faster insulin aspart ('closed-loop') with standard insulin therapy and a masked continuous glucose monitor ('control') in random order. The primary endpoint was time in target glucose range (5.6-10.0 mmol l.sup.-1). Thirteen participants received closed-loop first and thirteen received control therapy first. The proportion of time in target glucose range (5.6-10.0 mmol l.sup.-1; primary endpoint) was 52.8 [plus or minus] 12.5% with closed-loop versus 37.7 [plus or minus] 20.5% with control; mean difference, 15.1 percentage points (95% CI 8.0-22.2; P < 0.001). Mean glucose was lower with closed-loop than control (10.1 [plus or minus] 1.3 versus 11.6 [plus or minus] 2.8 mmol l.sup.-1; P = 0.003). Time in hypoglycemia ( A new randomized, crossover clinical trial testing rapid-acting insulin aspart delivered in a closed-loop system compared with standard care demonstrates increased time in range in patients with type 2 diabetes who require dialysis in the outpatient setting., Author(s): Charlotte K. Boughton [sup.1] [sup.2] , Afroditi Tripyla [sup.3] , Sara Hartnell [sup.2] , Aideen Daly [sup.1] , David Herzig [sup.3] , Malgorzata E. Wilinska [sup.1] , Cecilia Czerlau [...]
- Published
- 2021
- Full Text
- View/download PDF
13. New closed-loop insulin systems
- Author
-
Boughton, Charlotte K. and Hovorka, Roman
- Published
- 2021
- Full Text
- View/download PDF
14. Safety of User-Initiated Intensification of Insulin Delivery Using Cambridge Hybrid Closed-Loop Algorithm.
- Author
-
Ware, Julia, Wilinska, Malgorzata E., Ruan, Yue, Allen, Janet M., Boughton, Charlotte K., Hartnell, Sara, Bally, Lia, de Beaufort, Carine, Besser, Rachel E. J., Campbell, Fiona M., Draxlbauer, Katharine, Elleri, Daniela, Evans, Mark L., Fröhlich-Reiterer, Elke, Ghatak, Atrayee, Hofer, Sabine E., Kapellen, Thomas M., Leelarathna, Lalantha, Mader, Julia K., and Mubita, Womba M.
- Published
- 2024
- Full Text
- View/download PDF
15. CamAPS FX Hybrid Closed-Loop with Ultra-Rapid Lispro Compared with Standard Lispro in Adults with Type 1 Diabetes: A Double-Blind, Randomized, Crossover Study
- Author
-
Nwokolo, Munachiso, primary, Lakshman, Rama, additional, Hartnell, Sara, additional, Alwan, Heba, additional, Ware, Julia, additional, Allen, Janet M., additional, Wilinska, Malgorzata E., additional, Evans, Mark L., additional, Hovorka, Roman, additional, and Boughton, Charlotte K., additional
- Published
- 2023
- Full Text
- View/download PDF
16. Fully closed-loop insulin delivery in inpatients receiving nutritional support: a two-centre, open-label, randomised controlled trial
- Author
-
Boughton, Charlotte K, Bally, Lia, Martignoni, Franco, Hartnell, Sara, Herzig, David, Vogt, Andreas, Wertli, Maria M, Wilinska, Malgorzata E, Evans, Mark L, Coll, Anthony P, Stettler, Christoph, and Hovorka, Roman
- Published
- 2019
- Full Text
- View/download PDF
17. Diabetic Ketoacidosis at Onset of Type 1 Diabetes and Glycemic Outcomes with Closed-Loop Insulin Delivery.
- Author
-
Lakshman, Rama, Najami, Mazin, Allen, Janet M., Ware, Julia, Wilinska, Malgorzata E., Hartnell, Sara, Thankamony, Ajay, Randell, Tabitha, Ghatak, Atrayee, Besser, Rachel E.J., Elleri, Daniela, Trevelyan, Nicola, Campbell, Fiona M., Hovorka, Roman, and Boughton, Charlotte K.
- Published
- 2024
- Full Text
- View/download PDF
18. Consensus Recommendations for the Use of Automated Insulin Delivery Technologies in Clinical Practice
- Author
-
Phillip, Moshe, Nimri, Revital, Bergenstal, Richard M, Barnard-Kelly, Katharine, Danne, Thomas, Hovorka, Roman, Kovatchev, Boris P, Messer, Laurel H, Parkin, Christopher G, Ambler-Osborn, Louise, Amiel, Stephanie A, Bally, Lia, Beck, Roy W, Biester, Sarah, Biester, Torben, Blanchette, Julia E, Bosi, Emanuele, Boughton, Charlotte K, Breton, Marc D, Brown, Sue A, Buckingham, Bruce A, Cai, Albert, Carlson, Anders L, Castle, Jessica R, Choudhary, Pratik, Close, Kelly L, Cobelli, Claudio, Criego, Amy B, Davis, Elizabeth, de Beaufort, Carine, de Bock, Martin I, DeSalvo, Daniel J, DeVries, J Hans, Dovc, Klemen, Doyle, Francis J, Ekhlaspour, Laya, Shvalb, Naama Fisch, Forlenza, Gregory P, Gallen, Geraldine, Garg, Satish K, Gershenoff, Dana C, Gonder-Frederick, Linda A, Haidar, Ahmad, Hartnell, Sara, Heinemann, Lutz, Heller, Simon, Hirsch, Irl B, Hood, Korey K, Isaacs, Diana, Klonoff, David C, Kordonouri, Olga, Kowalski, Aaron, Laffel, Lori, Lawton, Julia, Lal, Rayhan A, Leelarathna, Lalantha, Maahs, David M, Murphy, Helen R, Nørgaard, Kirsten, O'Neal, David, Oser, Sean, Oser, Tamara, Renard, Eric, Riddell, Michael C, Rodbard, David, Russell, Steven J, Schatz, Desmond A, Shah, Viral N, Sherr, Jennifer L, Simonson, Gregg D, Wadwa, R Paul, Ward, Candice, Weinzimer, Stuart A, Wilmot, Emma G, Battelino, Tadej, General Internal Medicine, APH - Health Behaviors & Chronic Diseases, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism
- Subjects
closed-loop ,Endocrinology ,consensus recommendations ,automated insulin delivery ,type 1 diabetes ,Endocrinology, Diabetes and Metabolism ,610 Medicine & health ,610 Medizin und Gesundheit - Abstract
The significant and growing global prevalence of diabetes continues to challenge people with diabetes (PwD), healthcare providers, and payers. While maintaining near-normal glucose levels has been shown to prevent or delay the progression of the long-term complications of diabetes, a significant proportion of PwD are not attaining their glycemic goals. During the past 6 years, we have seen tremendous advances in automated insulin delivery (AID) technologies. Numerous randomized controlled trials and real-world studies have shown that the use of AID systems is safe and effective in helping PwD achieve their long-term glycemic goals while reducing hypoglycemia risk. Thus, AID systems have recently become an integral part of diabetes management. However, recommendations for using AID systems in clinical settings have been lacking. Such guided recommendations are critical for AID success and acceptance. All clinicians working with PwD need to become familiar with the available systems in order to eliminate disparities in diabetes quality of care. This report provides much-needed guidance for clinicians who are interested in utilizing AIDs and presents a comprehensive listing of the evidence payers should consider when determining eligibility criteria for AID insurance coverage.
- Published
- 2023
19. Implementation of fully closed-loop insulin delivery for inpatients with diabetes: Real-world outcomes
- Author
-
Boughton, Charlotte K, Hartnell, Sara, Hobday, Nicola, Lake, Andrea, Davenport, Katy, Daly, Aideen, Ward, Candice, Taylor, Caroline, Hovorka, Roman, Bansiya, Vishakha, Boughton, Charlotte K [0000-0003-3272-9544], Hovorka, Roman [0000-0003-2901-461X], and Apollo - University of Cambridge Repository
- Subjects
Male ,Blood Glucose ,closed-loop ,therapy ,Inpatients ,Cross-Over Studies ,Middle Aged ,in-patient diabetes ,Diabetes Mellitus, Type 1 ,Treatment Outcome ,Insulin Infusion Systems ,Humans ,Insulin ,Hypoglycemic Agents ,continuous glucose monitoring ,Female ,type 2 diabetes ,implementation ,Aged - Abstract
Funder: Addenbrooke's Charitable Trust, AIMS: Fully closed-loop insulin delivery has been shown in clinical trials to be safe and improve glucose control compared with standard insulin therapy in the inpatient setting. We investigated the feasibility of implementing the approved CamAPS HX fully closed-loop system in a hospital setting. METHODS: This implementation project was conducted in a large teaching hospital in Cambridge, UK. Healthcare professional training was multimodal including face-to-face workshops, online learning modules and supported by standard operating procedures. Set-up and maintenance of closed-loop devices were undertaken by the inpatient diabetes team. Selection of suitable patients was multidisciplinary and prioritised those with more challenging diabetes management. Demographic and clinical data were collected from electronic health records and diabetes data management platforms. RESULTS: In the 12 months since the closed-loop system was implemented, 32 inpatients (mean ± SD age 61 ± 16 years, 8 females, 24 males) used closed-loop insulin delivery during their admission, across medical and surgical wards in the hospital with a total of 555 days of closed-loop glucose control (median [IQR]: 14 [6, 22] days per inpatient). The time spent in target glucose range 3.9-10.0 mmol/L was 53.3 ± 18.3%. Mean glucose was 10.7 ± 1.9 mmol/L with 46.0 ± 18.2% of time spent with glucose >10.0 mmol/L. Time spent with sensor glucose below 3.9 mmol/L was low (median [IQR]: 0.38 [0.00, 0.85]). There were no episodes of severe hypoglycaemia or diabetic ketoacidosis during closed-loop use. CONCLUSIONS: We have demonstrated that the fully closed-loop system can be safely and effectively implemented by a diabetes outreach team in complex medical and surgical inpatients with challenging glycaemic control.
- Published
- 2023
20. Hybrid Closed-Loop with Faster Insulin Aspart Compared with Standard Insulin Aspart in Very Young Children with Type 1 Diabetes: A Double-Blind, Multicenter, Randomized, Crossover Study
- Author
-
Ware, Julia, Allen, Janet M, Boughton, Charlotte K, Cezar, Alina, Hartnell, Sara, Wilinska, Malgorzata E, Thankamony, Ajay, Deakin, Mark, Leyland, Hannah, Phelan, Karen, Thornborough, Keith, Hovorka, Roman, Ware, Julia [0000-0002-4497-0979], Boughton, Charlotte K [0000-0003-3272-9544], and Apollo - University of Cambridge Repository
- Subjects
Blood Glucose ,Toddlers ,Cross-Over Studies ,Endocrinology, Diabetes and Metabolism ,Aspart ,Very young children ,Artificial pancreas ,Medical Laboratory Technology ,Endocrinology ,Type 1 diabetes ,Diabetes Mellitus, Type 1 ,Double-Blind Method ,Child, Preschool ,Humans ,Hypoglycemic Agents ,Insulin ,Closed-loop insulin delivery ,Faster insulin aspart ,Child ,Insulin Aspart - Abstract
We evaluated the use of hybrid closed-loop (HCL) insulin delivery with faster insulin aspart (Fiasp) in very young children with type 1 diabetes (T1D). In a double-blind, multicenter, randomized, crossover study, children aged 2-6 years with T1D underwent two 8-week periods of HCL using CamAPS FX with Fiasp and standard insulin aspart (IAsp), in random order. Primary endpoint was between-treatment difference in time in target range 3.9-10.0 mmol/L. We randomized 25 participants: mean (±standard deviation) age 5.1 ± 1.3 years, baseline HbA1c 55 ± 9 mmol/mol. Time in range was not significantly different between interventions (64% ± 9% vs. 65% ± 9% for HCL with Fiasp vs. IAsp; mean difference -0.33% [95% confidence interval: -2.13 to 1.47; P = 0.71]). There was no significant difference in time with glucose
- Published
- 2023
21. Sleep Quality and Quantity in Caregivers of Children with Type 1 Diabetes Using Closed-Loop Insulin Delivery or a Sensor-Augmented Pump
- Author
-
Madrid-Valero, Juan J., primary, Ware, Julia, additional, Allen, Janet M., additional, Boughton, Charlotte K., additional, Hartnell, Sara, additional, Wilinska, Malgorzata E., additional, Thankamony, Ajay, additional, de Beaufort, Carine, additional, Schierloh, Ulrike, additional, Campbell, Fiona M., additional, Sibayan, Judy, additional, Bocchino, Laura E., additional, Kollman, Craig, additional, Hovorka, Roman, additional, Gregory, Alice M., additional, and Consortium, KidsAP, additional
- Published
- 2023
- Full Text
- View/download PDF
22. Time spent in hypoglycemia according to age and time-of-day: Observations during closed-loop insulin delivery
- Author
-
Alwan, Heba, primary, Ware, Julia, additional, Boughton, Charlotte K, additional, Wilinska, Malgorzata, additional, Allen, Janet M, additional, Lakshman, Rama, additional, Nwokolo, Munachiso, additional, Hartnell, Sara, additional, Bally, Lia, additional, de Beaufort, Carine, additional, Besser, Rachel Elizabeth Jane, additional, Campbell, Fiona, additional, Davis, Nikki, additional, Denver, Louise, additional, Evants, Mark L, additional, Fröhlich-Reiterer, Elke, additional, Ghatak, Atrayee, additional, Hofer, Sabine E., additional, Kapellen, Thomas M, additional, Leelarathna, Lalantha, additional, Mader, Julia K, additional, Narendran, Parth, additional, Rami-Merhar, Birgit, additional, Tauschmann, Martin, additional, Thabit, Hood, additional, thankamony, Ajay, additional, and Hovorka, Roman, additional
- Published
- 2023
- Full Text
- View/download PDF
23. Fully Closed-Loop Glucose Control Compared With Insulin Pump Therapy With Continuous Glucose Monitoring in Adults With Type 1 Diabetes and Suboptimal Glycemic Control: A Single-Center, Randomized, Crossover Study.
- Author
-
Boughton, Charlotte K., Hartnell, Sara, Lakshman, Rama, Nwokolo, Munachiso, Wilinska, Malgorzata E., Ware, Julia, Allen, Janet M., Evans, Mark L., and Hovorka, Roman
- Abstract
OBJECTIVE: We evaluated the safety and efficacy of fully closed-loop with ultrarapid insulin lispro in adults with type 1 diabetes and suboptimal glycemic control compared with insulin pump therapy with continuous glucose monitoring (CGM). RESEARCH DESIGN AND METHODS: This single-center, randomized, crossover study enrolled 26 adults with type 1 diabetes using insulin pump therapy with suboptimal glycemic control (mean ± SD, age 41 ± 12 years, HbA1c 9.2 ± 1.1% [77 ± 12 mmol/mol]). Participants underwent two 8-week periods of unrestricted living to compare fully closed-loop with ultrarapid insulin lispro (CamAPS HX system) with insulin pump therapy with CGM in random order. RESULTS: In an intention-to-treat analysis, the proportion of time glucose was in range (primary end point 3.9–10.0 mmol/L) was higher during closed-loop than during pump with CGM (mean ± SD 50.0 ± 9.6% vs. 36.2 ± 12.2%, mean difference 13.2 percentage points [95% CI 9.5, 16.9], P < 0.001). Time with glucose >10.0 mmol/L and mean glucose were lower during closed-loop than during pump with CGM (mean ± SD time >10.0 mmol/L: 49.0 ± 9.9 vs. 62.9 ± 12.6%, mean difference −13.3 percentage points [95% CI −17.2, −9.5], P < 0.001; mean ± SD glucose 10.7 ± 1.1 vs. 12.0 ± 1.6 mmol/L, mean difference −1.2 mmol/L [95% CI −1.8, −0.7], P < 0.001). The proportion of time with glucose <3.9 mmol/L was similar between periods (median [interquartile range (IQR)] closed-loop 0.88% [0.51–1.55] vs. pump with CGM 0.64% [0.28–1.10], P = 0.102). Total daily insulin requirements did not differ (median [IQR] closed-loop 51.9 units/day [35.7–91.2] vs. pump with CGM 50.7 units/day [34.0–70.0], P = 0.704). No severe hypoglycemia or ketoacidosis occurred. CONCLUSIONS: Fully closed-loop insulin delivery with CamAPS HX improved glucose control compared with insulin pump therapy with CGM in adults with type 1 diabetes and suboptimal glycemic control. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
24. Variation in the reporting of glucose values during simultaneous glucose sensor wear.
- Author
-
Sutton, Hannah, Boughton, Charlotte K, Allen, Janet M, Ware, Julia, Wilinska, Malgorzata E, Hartnell, Sara, Thankamony, Ajay, Randell, Tabitha, Ghatak, Atrayee, Besser, Rachel EJ, Elleri, Daniela, Trevelyan, Nicola, Campbell, Fiona M, and Hovorka, Roman
- Published
- 2023
- Full Text
- View/download PDF
25. Publisher Correction: Fully automated closed-loop glucose control compared with standard insulin therapy in adults with type 2 diabetes requiring dialysis: an open-label, randomized crossover trial
- Author
-
Boughton, Charlotte K., Tripyla, Afroditi, Hartnell, Sara, Daly, Aideen, Herzig, David, Wilinska, Malgorzata E., Czerlau, Cecilia, Fry, Andrew, Bally, Lia, and Hovorka, Roman
- Published
- 2021
- Full Text
- View/download PDF
26. The artificial pancreas
- Author
-
Boughton, Charlotte K. and Hovorka, Roman
- Published
- 2020
- Full Text
- View/download PDF
27. Sleep Quality and Quantity in Caregivers of Children with Type 1 Diabetes Using Closed-Loop Insulin Delivery or a Sensor-Augmented Pump
- Author
-
Madrid-Valero, Juan J., Ware, Julia, Allen, Janet M., Boughton, Charlotte K., Hartnell, Sara, Wilinska, Malgorzata E., Thankamony, Ajay, de Beaufort, Carine, Schierloh, Ulrike, Campbell, Fiona M., Sibayan, Judy, Bocchino, Laura E., Kollman, Craig, Hovorka, Roman, Gregory, Alice M., Consortium, KidsAP, Universidad de Alicante. Departamento de Psicología de la Salud, and Psicología Aplicada a la Salud y Comportamiento Humano (PSYBHE)
- Subjects
Caregivers ,Type 1 Diabetes ,Sleep ,Children - Abstract
Introduction. Parents of children living with type 1 diabetes (T1D) often report short and/or poor quality sleep. The development of closed-loop systems promises to transform the management of T1D. This study compared sleep quality and quantity in caregivers of children using a closed-loop system (CL) or sensor-augmented pump (SAP) therapy. Method. Data from sleep diaries, accelerometers, and questionnaires were provided by forty parents (classified as caregiver 1 (main analyses) or 2 (supplementary analyses) based on their contribution towards treatment management) of 21 very young children aged 1 to 7 years living with T1D (mean age: 4.7 (SD = 1.7)). Assessments were made at a single post-randomisation time point when the child was completing either the 16-week CL arm (n = 10) or the 16-week SAP arm (n = 11) of the main study. Results. Overall, there was a mixed pattern of results and group differences were not statistically significant at the p
- Published
- 2023
28. Time spent in hypoglycemia according to age and time-of-day: Observations during closed-loop insulin delivery
- Author
-
Alwan, Heba, Ware, Julia, Boughton, Charlotte K, Wilinska, Malgorzata E, Allen, Janet M, Lakshman, Rama, Nwokolo, Munachiso, Hartnell, Sara, Bally, Lia, De Beaufort, Carine, Besser, Rachel EJ, Campbell, Fiona M, Davis, Nikki, Denvir, Louise, Evans, Mark L, Fröhlich-Reiterer, Elke, Ghatak, Atrayee, Hofer, Sabine E, Kapellen, Thomas M, Leelarathna, Lalantha, Mader, Julia K, Narendran, Parth, Rami-Mehrar, Birgit, Tauschmann, Martin, Thabit, Hood, Thankamony, Ajay, Hovorka, Roman, Alwan, Heba [0000-0001-5516-6022], Ware, Julia [0000-0002-4497-0979], Boughton, Charlotte K [0000-0003-3272-9544], Lakshman, Rama [0000-0002-4341-1307], Bally, Lia [0000-0003-1993-7672], Besser, Rachel EJ [0000-0002-4645-6324], Mader, Julia K [0000-0001-7854-4233], and Apollo - University of Cambridge Repository
- Subjects
Adult ,Blood Glucose ,Adolescent ,Endocrinology, Diabetes and Metabolism ,Artificial pancreas ,610 Medicine & health ,Young Adult ,Insulin pump therapy ,Endocrinology ,Insulin Infusion Systems ,360 Social problems & social services ,Insulin, Regular, Human ,Humans ,Insulin ,Hypoglycemic Agents ,Closed-loop insulin delivery ,Child ,Aged ,Retrospective Studies ,Cross-Over Studies ,Middle Aged ,Hypoglycemia ,Medical Laboratory Technology ,Type 1 diabetes ,Diabetes Mellitus, Type 1 ,Treatment Outcome ,Child, Preschool ,Randomized trial - Abstract
Objective: We aimed to assess whether percentage of time spent in hypoglycemia during closed-loop insulin delivery differs by age group and time of day. Methods: We retrospectively analyzed data from hybrid closed-loop studies involving young children (2-7 years), children and adolescents (8-18 years), adults (19-59 years), and older adults (≥60 years) with type 1 diabetes. Main outcome was time spent in hypoglycemia
- Published
- 2023
- Full Text
- View/download PDF
29. Implementation of fully closed‐loop insulin delivery for inpatients with diabetes: Real‐world outcomes
- Author
-
Boughton, Charlotte K., primary, Hartnell, Sara, additional, Hobday, Nicola, additional, Lake, Andrea, additional, Davenport, Katy, additional, Daly, Aideen, additional, Ward, Candice, additional, Taylor, Caroline, additional, Hovorka, Roman, additional, and Bansiya, Vishakha, additional
- Published
- 2023
- Full Text
- View/download PDF
30. Insulin Requirements Over Eight Weeks of Fully Closed-Loop Insulin Delivery in Adults With Type 2 Diabetes
- Author
-
Lakshman, Rama, primary, Daly, Aideen B., additional, Nwokolo, Munachiso, additional, Hartnell, Sara, additional, Wilinska, Malgorzata E., additional, Cezar, Alina, additional, Evans, Mark L., additional, Hovorka, Roman, additional, and Boughton, Charlotte K., additional
- Published
- 2023
- Full Text
- View/download PDF
31. Correction to: New closed-loop insulin systems
- Author
-
Boughton, Charlotte K. and Hovorka, Roman
- Published
- 2021
- Full Text
- View/download PDF
32. Sleep Quality and Quantity in Caregivers of Children with Type 1 Diabetes Using Closed-Loop Insulin Delivery or a Sensor-Augmented Pump
- Author
-
Universidad de Alicante. Departamento de Psicología de la Salud, Madrid-Valero, Juan J., Ware, Julia, Allen, Janet M., Boughton, Charlotte K., Hartnell, Sara, Wilinska, Malgorzata E., Thankamony, Ajay, de Beaufort, Carine, Schierloh, Ulrike, Campbell, Fiona M., Sibayan, Judy, Bocchino, Laura E., Kollman, Craig, Hovorka, Roman, Gregory, Alice M., KidsAP Consortium, Universidad de Alicante. Departamento de Psicología de la Salud, Madrid-Valero, Juan J., Ware, Julia, Allen, Janet M., Boughton, Charlotte K., Hartnell, Sara, Wilinska, Malgorzata E., Thankamony, Ajay, de Beaufort, Carine, Schierloh, Ulrike, Campbell, Fiona M., Sibayan, Judy, Bocchino, Laura E., Kollman, Craig, Hovorka, Roman, Gregory, Alice M., and KidsAP Consortium
- Abstract
Introduction. Parents of children living with type 1 diabetes (T1D) often report short and/or poor quality sleep. The development of closed-loop systems promises to transform the management of T1D. This study compared sleep quality and quantity in caregivers of children using a closed-loop system (CL) or sensor-augmented pump (SAP) therapy. Method. Data from sleep diaries, accelerometers, and questionnaires were provided by forty parents (classified as caregiver 1 (main analyses) or 2 (supplementary analyses) based on their contribution towards treatment management) of 21 very young children aged 1 to 7 years living with T1D (mean age: 4.7 (SD = 1.7)). Assessments were made at a single post-randomisation time point when the child was completing either the 16-week CL arm (n = 10) or the 16-week SAP arm (n = 11) of the main study. Results. Overall, there was a mixed pattern of results and group differences were not statistically significant at the level. However, when we consider the direction of results and results from caregiver 1, sleep diary data showed that parents of the CL (as compared to the SAP) group reported a shorter sleep duration but better sleep quality, fewer awakenings, and less wake after sleep onset (WASO). Actiwatch data showed that caregiver 1 of the CL (as compared to the SAP) group had a shorter sleep latency; greater sleep efficiency; and less wake after sleep onset. Results from the Pittsburgh Sleep Quality Index also showed better sleep quality for caregiver 1 of the CL group as compared to the SAP group. Conclusions. Results from this study suggest that sleep quality and quantity in parents of children using CL were not significantly different to those using SAP. Considering effect sizes and the direction of the non-significant results, CL treatment could be associated with better sleep quality in the primary caregiver. However, further research is needed to confirm these findings. This trial is registered with NCT05158816.
- Published
- 2023
33. Lived experience of CamAPS FX closed loop system in youth with type 1 diabetes and their parents
- Author
-
Hood, Korey K, Garcia-Willingham, Natasha, Hanes, Sarah, Tanenbaum, Molly L, Ware, Julia, Boughton, Charlotte K, Allen, Janet M, Wilinska, Malgorzata E, Tauschmann, Martin, Denvir, Louise, Thankamony, Ajay, Campbell, Fiona, Wadwa, R Paul, Buckingham, Bruce A, Davis, Nikki, DiMeglio, Linda A, Mauras, Nelly, Besser, Rachel EJ, Ghatak, Atrayee, Weinzimer, Stuart A, Fox, D Steven, Kanapka, Lauren, Kollman, Craig, Sibayan, Judy, Beck, Roy W, Hovorka, Roman, DAN05 Consortium, Hood, Korey K [0000-0001-5730-7749], Boughton, Charlotte K [0000-0003-3272-9544], and Apollo - University of Cambridge Repository
- Subjects
Blood Glucose ,Parents ,Diabetes Mellitus, Type 1 ,Treatment Outcome ,Insulin Infusion Systems ,Adolescent ,Blood Glucose Self-Monitoring ,Quality of Life ,Humans ,Insulin ,Hypoglycemic Agents ,Child - Abstract
AIM: To examine changes in the lived experience of type 1 diabetes after use of hybrid closed loop (CL), including the CamAPS FX CL system. MATERIALS AND METHODS: The primary study was conducted as an open-label, single-period, randomized, parallel design contrasting CL versus insulin pump (with or without continuous glucose monitoring). Participants were asked to complete patient-reported outcomes before starting CL and 3 and 6 months later. Surveys assessed diabetes distress, hypoglycaemia concerns and quality of life. Qualitative focus group data were collected at the completion of the study. RESULTS: In this sample of 98 youth (age range 6-18, mean age 12.7 ± 2.8 years) and their parents, CL use was not associated with psychosocial benefits overall. However, the subgroup (n = 12) using the CamAPS FX system showed modest improvements in quality of life and parent distress, reinforced by both survey (p < .05) and focus group responses. There were no negative effects of CL use reported by study participants. CONCLUSIONS: Closed loop use via the CamAPS FX system was associated with modest improvements in aspects of the lived experience of managing type 1 diabetes in youth and their families. Further refinements of the system may optimize the user experience.
- Published
- 2022
- Full Text
- View/download PDF
34. Evaluating the Impact of Applying Personal Glucose Targets in a Closed-Loop System for People With Type 1 Diabetes
- Author
-
Fattah, Mustafa, primary, Boughton, Charlotte K., additional, Ware, Julia, additional, Allen, Janet M., additional, Hartnell, Sara, additional, Willinska, Malgorzata E., additional, Thankamony, Ajay, additional, de Beaufort, Carine, additional, Campbell, Fiona M., additional, Fröhlich-Reiterer, Elke, additional, Hofer, Sabine E., additional, Kapellen, Thomas M., additional, Rami-Merhar, Birgit, additional, Ghatak, Atrayee, additional, Randell, Tabitha L., additional, Besser, Rachel E. J., additional, Elleri, Daniela, additional, Trevelyan, Nicola, additional, Denvir MD, Louise, additional, Davis, Nikki, additional, Bally, Lia, additional, Thabit, Hood, additional, Leelarathna, Lalantha, additional, Evans, Mark L., additional, Mader, Julia K., additional, and Hovorka, Roman, additional
- Published
- 2022
- Full Text
- View/download PDF
35. Safety of User-Initiated Intensification of Insulin Delivery Using Cambridge Hybrid Closed-Loop Algorithm
- Author
-
Ware, Julia, primary, Wilinska, Malgorzata E., additional, Ruan, Yue, additional, Allen, Janet M., additional, Boughton, Charlotte K., additional, Hartnell, Sara, additional, Bally, Lia, additional, de Beaufort, Carine, additional, Besser, Rachel E. J., additional, Campbell, Fiona M., additional, Draxlbauer, Katharine, additional, Elleri, Daniela, additional, Evans, Mark L., additional, Fröhlich-Reiterer, Elke, additional, Ghatak, Atrayee, additional, Hofer, Sabine E., additional, Kapellen, Thomas M., additional, Leelarathna, Lalantha, additional, Mader, Julia K., additional, Mubita, Womba M., additional, Narendran, Parth, additional, Poettler, Tina, additional, Rami-Merhar, Birgit, additional, Tauschmann, Martin, additional, Randell, Tabitha, additional, Thabit, Hood, additional, Thankamony, Ajay, additional, Trevelyan, Nicola, additional, and Hovorka, Roman, additional
- Published
- 2022
- Full Text
- View/download PDF
36. Parents' experiences of using remote monitoring technology to manage type 1 diabetes in very young children during a clinical trial: Qualitative study
- Author
-
Hart, Ruth I, Kimbell, Barbara, Rankin, David, Allen, Janet M, Boughton, Charlotte K, Campbell, Fiona, De Beaufort, Carine, Fröhlich-Reiterer, Elke, Ware, Julia, Hofer, Sabine E, Kapellen, Thomas M, Rami-Merhar, Birgit, Thankamony, Ajay, Hovorka, Roman, Lawton, Julia, KidsAP Consortium, Hart, Ruth I [0000-0003-2129-9163], Kimbell, Barbara [0000-0003-4510-9862], Rankin, David [0000-0002-5835-3402], Boughton, Charlotte K [0000-0003-3272-9544], Hovorka, Roman [0000-0003-2901-461X], Lawton, Julia [0000-0002-8016-7374], and Apollo - University of Cambridge Repository
- Subjects
young children ,Blood Glucose ,Parents ,Clinical Trials as Topic ,type 1 diabetes ,sensor-augmented pump therapy ,Blood Glucose Self-Monitoring ,Infant ,Diabetes Mellitus, Type 1 ,Insulin Infusion Systems ,Child, Preschool ,Remote Sensing Technology ,Humans ,Insulin ,closed-loop system ,Child ,qualitative research ,remote monitoring - Abstract
Funder: National Institute for Health Research Cambridge Biomedical Research Centre, AIMS: To explore parents' experiences of using remote monitoring technology when caring for a very young child with type 1 diabetes during a clinical trial. METHODS: Interviews were conducted with parents of 30 children (aged 1-7 years) participating in a trial (the KidsAP02 study) comparing hybrid closed-loop insulin delivery with sensor-augmented pump therapy. In both arms, parents had access to remote monitoring technology. Data analysis focused on identification of descriptive themes. RESULTS: Remote monitoring technology gave parents improved access to data which helped them pre-empt and manage glucose excursions. Parents observed how, when children were in their own care, they could be more absent while present, as their attention could shift to non-diabetes-related activities. Conversely, when children were others' care, remote monitoring enabled parents to be present while absent, by facilitating oversight and collaboration with caregivers. Parents described how remote monitoring made them feel more confident allowing others to care for their children. Parents' confidence increased when using a hybrid closed-loop system, as less work was required to keep glucose in range. Benefits to children were also highlighted, including being able to play and sleep uninterrupted and attend parties and sleepovers without their parents. While most parents welcomed the increased sense of control remote monitoring offered, some noted downsides, such as lack of respite from caregiving responsibilities. CONCLUSIONS: Remote monitoring can offer manifold benefits to both parents and very young children with type 1 diabetes. Some parents, however, may profit from opportunities to take 'time out'.
- Published
- 2022
- Full Text
- View/download PDF
37. Closed-Loop Therapy and Preservation of C-Peptide Secretion in Type 1 Diabetes
- Author
-
Boughton, Charlotte K, Allen, Janet M, Ware, Julia, Wilinska, Malgorzata E, Hartnell, Sara, Thankamony, Ajay, Randell, Tabitha, Ghatak, Atrayee, Besser, Rachel EJ, Elleri, Daniela, Trevelyan, Nicola, Campbell, Fiona M, Sibayan, Judy, Calhoun, Peter, Bailey, Ryan, Dunseath, Gareth, Hovorka, Roman, CLOuD Consortium, Besser, Rachel EJ [0000-0002-4645-6324], Hovorka, Roman [0000-0003-2901-461X], and Apollo - University of Cambridge Repository
- Subjects
Blood Glucose ,Diabetes Mellitus, Type 1 ,Insulin Infusion Systems ,Adolescent ,C-Peptide ,Humans ,Hypoglycemic Agents ,Insulin ,Child - Abstract
BACKGROUND: Whether improved glucose control with hybrid closed-loop therapy can preserve C-peptide secretion as compared with standard insulin therapy in persons with new-onset type 1 diabetes is unclear. METHODS: In a multicenter, open-label, parallel-group, randomized trial, we assigned youths 10.0 to 16.9 years of age within 21 days after a diagnosis of type 1 diabetes to receive hybrid closed-loop therapy or standard insulin therapy (control) for 24 months. The primary end point was the area under the curve (AUC) for the plasma C-peptide level (after a mixed-meal tolerance test) at 12 months after diagnosis. The analysis was performed on an intention-to-treat basis. RESULTS: A total of 97 participants (mean [±SD] age, 12±2 years) underwent randomization: 51 were assigned to receive closed-loop therapy and 46 to receive control therapy. The AUC for the C-peptide level at 12 months (primary end point) did not differ significantly between the two groups (geometric mean, 0.35 pmol per milliliter [interquartile range, 0.16 to 0.49] with closed-loop therapy and 0.46 pmol per milliliter [interquartile range, 0.22 to 0.69] with control therapy; mean adjusted difference, -0.06 pmol per milliliter [95% confidence interval {CI}, -0.14 to 0.03]). There was not a substantial between-group difference in the AUC for the C-peptide level at 24 months (geometric mean, 0.18 pmol per milliliter [interquartile range, 0.06 to 0.22] with closed-loop therapy and 0.24 pmol per milliliter [interquartile range, 0.05 to 0.30] with control therapy; mean adjusted difference, -0.04 pmol per milliliter [95% CI, -0.14 to 0.06]). The arithmetic mean glycated hemoglobin level was lower in the closed-loop group than in the control group by 4 mmol per mole (0.4 percentage points; 95% CI, 0 to 8 mmol per mole [0.0 to 0.7 percentage points]) at 12 months and by 11 mmol per mole (1.0 percentage points; 95% CI, 7 to 15 mmol per mole [0.5 to 1.5 percentage points]) at 24 months. Five cases of severe hypoglycemia occurred in the closed-loop group (in 3 participants), and one occurred in the control group; one case of diabetic ketoacidosis occurred in the closed-loop group. CONCLUSIONS: In youths with new-onset type 1 diabetes, intensive glucose control for 24 months did not appear to prevent the decline in residual C-peptide secretion. (Funded by the National Institute for Health and Care Research and others; CLOuD ClinicalTrials.gov number, NCT02871089.).
- Published
- 2022
38. Closed-Loop Therapy and Preservation of C-Peptide Secretion in Type 1 Diabetes
- Author
-
Boughton, Charlotte K., primary, Allen, Janet M., additional, Ware, Julia, additional, Wilinska, Malgorzata E., additional, Hartnell, Sara, additional, Thankamony, Ajay, additional, Randell, Tabitha, additional, Ghatak, Atrayee, additional, Besser, Rachel E.J., additional, Elleri, Daniela, additional, Trevelyan, Nicola, additional, Campbell, Fiona M., additional, Sibayan, Judy, additional, Calhoun, Peter, additional, Bailey, Ryan, additional, Dunseath, Gareth, additional, and Hovorka, Roman, additional
- Published
- 2022
- Full Text
- View/download PDF
39. Consensus Recommendations for the Use of Automated Insulin Delivery Technologies in Clinical Practice
- Author
-
Phillip, Moshe, primary, Nimri, Revital, additional, Bergenstal, Richard M, additional, Barnard-Kelly, Katharine, additional, Danne, Thomas, additional, Hovorka, Roman, additional, Kovatchev, Boris P, additional, Messer, Laurel H, additional, Parkin, Christopher G, additional, Ambler-Osborn, Louise, additional, Amiel, Stephanie A, additional, Bally, Lia, additional, Beck, Roy W, additional, Biester, Sarah, additional, Biester, Torben, additional, Blanchette, Julia E, additional, Bosi, Emanuele, additional, Boughton, Charlotte K, additional, Breton, Marc D, additional, Brown, Sue A, additional, Buckingham, Bruce A, additional, Cai, Albert, additional, Carlson, Anders L, additional, Castle, Jessica R, additional, Choudhary, Pratik, additional, Close, Kelly L, additional, Cobelli, Claudio, additional, Criego, Amy B, additional, Davis, Elizabeth, additional, de Beaufort, Carine, additional, de Bock, Martin I, additional, DeSalvo, Daniel J, additional, DeVries, J Hans, additional, Dovc, Klemen, additional, Doyle, Francis J, additional, Ekhlaspour, Laya, additional, Shvalb, Naama Fisch, additional, Forlenza, Gregory P, additional, Gallen, Geraldine, additional, Garg, Satish K, additional, Gershenoff, Dana C, additional, Gonder-Frederick, Linda A, additional, Haidar, Ahmad, additional, Hartnell, Sara, additional, Heinemann, Lutz, additional, Heller, Simon, additional, Hirsch, Irl B, additional, Hood, Korey K, additional, Isaacs, Diana, additional, Klonoff, David C, additional, Kordonouri, Olga, additional, Kowalski, Aaron, additional, Laffel, Lori, additional, Lawton, Julia, additional, Lal, Rayhan A, additional, Leelarathna, Lalantha, additional, Maahs, David M, additional, Murphy, Helen R, additional, Nørgaard, Kirsten, additional, O’Neal, David, additional, Oser, Sean, additional, Oser, Tamara, additional, Renard, Eric, additional, Riddell, Michael C, additional, Rodbard, David, additional, Russell, Steven J, additional, Schatz, Desmond A, additional, Shah, Viral N, additional, Sherr, Jennifer L, additional, Simonson, Gregg D, additional, Wadwa, R Paul, additional, Ward, Candice, additional, Weinzimer, Stuart A, additional, Wilmot, Emma G, additional, and Battelino, Tadej, additional
- Published
- 2022
- Full Text
- View/download PDF
40. Hybrid Closed-loop to Manage Gastroparesis in People With Type 1 Diabetes: a Case Series
- Author
-
Daly, Aideen, Hartnell, Sara, Boughton, Charlotte K, Evans, Mark, Daly, Aideen [0000-0001-5003-9630], Boughton, Charlotte K [0000-0003-3272-9544], Evans, Mark [0000-0001-8122-8987], and Apollo - University of Cambridge Repository
- Subjects
Blood Glucose ,Diabetes Mellitus, Type 1 ,Gastroparesis ,Insulin Infusion Systems ,diabetes technology ,type 1 diabetes ,Blood Glucose Self-Monitoring ,Humans ,Hypoglycemic Agents ,Insulin ,continuous glucose monitoring ,hybrid closed-loop - Abstract
BACKGROUND: Gastroparesis is associated with unpredictable gastric emptying and can lead to erratic glucose profiles and negative impacts on quality-of-life. Many people with gastroparesis are unable to meet glycemic targets and there is a need for new approaches for this population. Hybrid closed-loop systems improve glucose control and quality-of-life but evidence for their use in people with diabetic gastroparesis is limited. METHODS: We present a narrative review of the challenges associated with type 1 diabetes management for people with gastroparesis and present a case series of 7 people with type 1 diabetes and gastroparesis. We compare glycemic control before and during the first 12 months of hybrid closed-loop therapy. Data were analyzed using electronic patient records and glucose management platforms. We also discuss future advancements for closed-loop systems that may benefit this population. RESULTS: Five of 7 patients had data available for time in range before and during hybrid closed-loop therapy, and all had an improvement in percentage time in target glucose range, with the overall mean time in range increasing from 26.0% ± 15.7% to 58.4% ± 8.6% during HCL use, (P = .004). There were significant reductions in HbA1c (83 ± 9 mmol/mol to 71 ± 14 mmol/mol) and mean glucose from 13.0 ± 1.7 mmol/L (234 ± 31 mg/dL) to 10.0 ± 0.7 mmol/L (180 ± 13 mg/dL) with use of a hybrid closed-loop system. Importantly, this was achieved without an increase in time in hypoglycemia (P = .50). CONCLUSION: Hybrid closed-loop systems may represent a valuable approach to improve glycemic control for people with type 1 diabetes and gastroparesis. Prospective studies are required to confirm these findings.
- Published
- 2021
- Full Text
- View/download PDF
41. 288-OR: Effect of 24 Months of Optimised Glucose Control on Residual C-Peptide Secretion in Youth with New Onset Type 1 Diabetes (T1D)
- Author
-
BOUGHTON, CHARLOTTE K., primary, WARE, JULIA, additional, ALLEN, JANET M., additional, WILINSKA, MALGORZATA E., additional, HARTNELL, SARA, additional, THANKAMONY, AJAY, additional, RANDELL, TABITHA, additional, GHATAK, ATRAYEE, additional, BESSER, RACHEL, additional, ELLERI, DANIELA, additional, TREVELYAN, NICOLA, additional, CAMPBELL, FIONA, additional, SIBAYAN, JUDY, additional, BAILEY, RYAN, additional, CALHOUN, PETER, additional, DUNSEATH, GARETH J., additional, HOVORKA, ROMAN, additional, and CONSORTIUM, CLOUD, additional
- Published
- 2022
- Full Text
- View/download PDF
42. User Engagement With the CamAPS FX Hybrid Closed-Loop App According to Age and User Characteristics
- Author
-
Chen, Natalie S, Boughton, Charlotte K, Hartnell, Sara, Fuchs, Julia, Allen, Janet M, Willinska, Malgorzata E, Thankamony, Ajay, De Beaufort, Carine, Campbell, Fiona M, Fröhlich-Reiterer, Elke, Hofer, Sabine E, Kapellen, Thomas M, Rami-Merhar, Birgit, Ghatak, Atrayee, Randell, Tabitha L, Besser, Rachel EJ, Elleri, Daniela, Trevelyan, Nicola, Denvir, Louise, Davis, Nikki, Gurnell, Eleanor, Lindsay, Robert, Morris, Damian, Scott, Eleanor M, Bally, Lia, Thabit, Hood, Leelarathna, Lalantha, Evans, Mark L, Murphy, Helen R, Mader, Julia K, Hovorka, Roman, AiDAPT, AP@Home04, Boughton, Charlotte K [0000-0003-3272-9544], Campbell, Fiona M [0000-0002-7618-6759], Lindsay, Robert [0000-0002-9868-5217], Scott, Eleanor M [0000-0001-5395-8261], Bally, Lia [0000-0003-1993-7672], Mader, Julia K [0000-0001-7854-4233], Hovorka, Roman [0000-0003-2901-461X], and Apollo - University of Cambridge Repository
- Subjects
Diabetes Mellitus, Type 1 ,Insulin Infusion Systems ,Humans ,Mobile Applications - Abstract
CamAPS FX (CamDiab, Cambridge, UK) is a hybrid closed-loop app hosting the Cambridge closed-loop algorithm on an Android smartphone, and is approved in the EU for use in children ≥1 year, and adults (including during pregnancy) with type 1 diabetes (T1D). The interoperable CamAPS FX app receives glucose data from a compatible CGM system (Dexcom G6; Dexcom, San Diego, CA), connects to a compatible insulin pump (Dana Diabecare RS and DANA-i; Sooil, Seoul, South Korea) to direct glucose-responsive insulin delivery every 8-12 minutes, includes a bolus calculator allowing discrete bolusing via the app, and streams data in real-time to cloud-based diabetes data repositories (Diasend/Glooko, Gothenburg, Sweden).
- Published
- 2021
43. Hybrid closed‐loop glucose control with faster insulin aspart compared with standard insulin aspart in adults with type 1 diabetes: A double‐blind, multicentre, multinational, randomized, crossover study
- Author
-
Boughton, Charlotte K., Hartnell, Sara, Thabit, Hood, Poettler, Tina, Herzig, David, Wilinska, Malgorzata E., Ashcroft, Nicole L., Sibayan, Judy, Cohen, Nathan, Calhoun, Peter, Bally, Lia, Mader, Julia K., Evans, Mark, Leelarathna, Lalantha, Hovorka, Roman, Boughton, Charlotte K. [0000-0003-3272-9544], Herzig, David [0000-0003-1028-9445], Calhoun, Peter [0000-0002-5325-7200], Bally, Lia [0000-0003-1993-7672], Evans, Mark [0000-0001-8122-8987], and Apollo - University of Cambridge Repository
- Subjects
type 1 diabetes ,artificial pancreas ,aspart ,faster insulin aspart ,continuous glucose monitoring ,ORIGINAL ARTICLES ,insulin pump therapy ,ORIGINAL ARTICLE ,closed‐loop insulin delivery - Abstract
Aim: To evaluate the use of hybrid closed‐loop glucose control with faster‐acting insulin aspart (Fiasp) in adults with type 1 diabetes (T1D). Research Design and Methods: In a double‐blind, multinational, randomized, crossover study, 25 adults with T1D using insulin pump therapy (mean ± SD, age 38 ± 9 years, HbA1c 7.4% ± 0.8% [57 ± 8 mmol/mol]) underwent two 8‐week periods of unrestricted living comparing hybrid closed‐loop with Fiasp and hybrid closed‐loop with standard insulin aspart in random order. During both interventions the CamAPS FX closed‐loop system incorporating the Cambridge model predictive control algorithm was used. Results: In an intention‐to‐treat analysis, the proportion of time sensor glucose was in the target range (3.9–10.0 mmol/L; primary endpoint) was not different between interventions (75% ± 8% vs. 75% ± 8% for hybrid closed‐loop with Fiasp vs. hybrid closed‐loop with standard insulin aspart; mean‐adjusted difference −0.6% [95% CI −1.8% to 0.7%]; p < .001 for non‐inferiority [non‐inferiority margin 5%]). The proportion of time with sensor glucose less than 3.9 mmol/L (median [IQR] 2.4% [1.2%–3.2%] vs. 2.9% [1.7%–4.0%]; p = .01) and less than 3.0 mmol/L (median [IQR] 0.4% [0.2%–0.7%] vs. 0.7% [0.2%–0.9%]; p = .03) was reduced with Fiasp versus standard insulin aspart. There was no difference in mean glucose (8.1 ± 0.8 vs. 8.0 ± 0.8 mmol/L; p = .13) or glucose variability (SD of sensor glucose 2.9 ± 0.5 vs. 2.9 ± 0.5 mmol/L; p = .90). Total daily insulin requirements did not differ (49 ± 15 vs. 49 ± 15 units/day; p = .45). No severe hypoglycaemia or ketoacidosis occurred. Conclusions: The use of Fiasp in the CamAPS FX closed‐loop system may reduce hypoglycaemia without compromising glucose control compared with standard insulin aspart in adults with T1D.
- Published
- 2021
- Full Text
- View/download PDF
44. Cambridge hybrid closed-loop algorithm in children and adolescents with type 1 diabetes: a multicentre 6-month randomised controlled trial
- Author
-
Ware, Julia, primary, Boughton, Charlotte K, additional, Allen, Janet M, additional, Wilinska, Malgorzata E, additional, Tauschmann, Martin, additional, Denvir, Louise, additional, Thankamony, Ajay, additional, Campbell, Fiona M, additional, Wadwa, R Paul, additional, Buckingham, Bruce A, additional, Davis, Nikki, additional, DiMeglio, Linda A, additional, Mauras, Nelly, additional, Besser, Rachel E J, additional, Ghatak, Atrayee, additional, Weinzimer, Stuart A, additional, Hood, Korey K, additional, Fox, D Steven, additional, Kanapka, Lauren, additional, Kollman, Craig, additional, Sibayan, Judy, additional, Beck, Roy W, additional, Hovorka, Roman, additional, Hovorka, R, additional, Acerini, C L, additional, Thankamony, A, additional, Allen, J M, additional, Boughton, C K, additional, Dovc, K, additional, Dunger, D B, additional, Ware, J, additional, Musolino, G, additional, Tauschmann, M, additional, Wilinska, M E, additional, Hayes, J F, additional, Hartnell, S, additional, Slegtenhorst, S, additional, Ruan, Y, additional, Haydock, M, additional, Mangat, J, additional, Denvir, L, additional, Kanthagnany, SK, additional, Law, J, additional, Randell, T, additional, Sachdev, P, additional, Saxton, M, additional, Coupe, A, additional, Stafford, S, additional, Ball, A, additional, Keeton, R, additional, Cresswell, R, additional, Crate, L, additional, Cripps, H, additional, Fazackerley, H, additional, Looby, L, additional, Navarra, H, additional, Saddington, C, additional, Smith, V, additional, Verhoeven, V, additional, Bratt, S, additional, Khan, N, additional, Moyes, L, additional, Sandhu, K, additional, West, C, additional, Wadwa, R P, additional, Alonso, G, additional, Forlenza, G, additional, Slover, R, additional, Towers, L, additional, Berget, C, additional, Coakley, A, additional, Escobar, E, additional, Jost, E, additional, Lange, S, additional, Messer, L, additional, Thivener, K, additional, Campbell, F M, additional, Yong, J, additional, Metcalfe, E, additional, Allen, M, additional, Ambler, S, additional, Waheed, S, additional, Exall, J, additional, Tulip, J, additional, Buckingham, B A, additional, Ekhlaspour, L, additional, Maahs, D, additional, Norlander, L, additional, Jacobson, T, additional, Twon, M, additional, Weir, C, additional, Leverenz, B, additional, Keller, J, additional, Davis, N, additional, Kumaran, A, additional, Trevelyan, N, additional, Dewar, H, additional, Price, G, additional, Crouch, G, additional, Ensom, R, additional, Haskell, L, additional, Lueddeke, LM, additional, Mauras, N, additional, Benson, M, additional, Bird, K, additional, Englert, K, additional, Permuy, J, additional, Ponthieux, K, additional, Marrero-Hernandez, J, additional, DiMeglio, L A, additional, Ismail, H, additional, Jolivette, H, additional, Sanchez, J, additional, Woerner, S, additional, Kirchner, M, additional, Mullen, M, additional, Tebbe, M, additional, Besser, R EJ, additional, Basu, S, additional, London, R, additional, Makaya, T, additional, Ryan, F, additional, Megson, C, additional, Bowen-Morris, J, additional, Haest, J, additional, Law, R, additional, Stamford, I, additional, Ghatak, A, additional, Deakin, M, additional, Phelan, K, additional, Thornborough, K, additional, Shakeshaft, J, additional, Weinzimer, S A, additional, Cengiz, E, additional, Sherr, J L, additional, Van Name, M, additional, Weyman, K, additional, Carria, L, additional, Steffen, A, additional, Zgorski, M, additional, Sibayan, J, additional, Beck, R W, additional, Borgman, S, additional, Davis, J, additional, Rusnak, J, additional, Hellman, A, additional, Cheng, P, additional, Kanapka, L, additional, Kollman, C, additional, McCarthy, C, additional, Chalasani, S, additional, Hood, K K, additional, Hanes, S, additional, Viana, J, additional, Lanning, M, additional, Fox, D S, additional, Arreaza-Rubin, G, additional, Eggerman, T, additional, Green, N, additional, Janicek, R, additional, Gabrielson, D, additional, Belle, S H, additional, Castle, J, additional, Green, J, additional, Legault, L, additional, Willi, S M, additional, and Wysham, C, additional
- Published
- 2022
- Full Text
- View/download PDF
45. Hybrid closed-loop glucose control compared with sensor augmented pump therapy in older adults with type 1 diabetes: an open-label multicentre, multinational, randomised, crossover study
- Author
-
Boughton, Charlotte K, primary, Hartnell, Sara, additional, Thabit, Hood, additional, Mubita, Womba M, additional, Draxlbauer, Katharine, additional, Poettler, Tina, additional, Wilinska, Malgorzata E, additional, Hood, Korey K, additional, Mader, Julia K, additional, Narendran, Parth, additional, Leelarathna, Lalantha, additional, Evans, Mark L, additional, and Hovorka, Roman, additional
- Published
- 2022
- Full Text
- View/download PDF
46. A Randomized Closed-loop Trial in Very Young Children with Type 1 Diabetes
- Author
-
Ware, Julia, Allen, Janet M, Boughton, Charlotte K, Wilinska, Malgorzata E, Hartnell, Sara, Thankamony, Ajay, Carine de Beaufort, Carine, Schierloh, Ulrike, Froehlich- Reiterer, Elke, Mader, Julia K, Kapellen, Thomas M, Rami-Merhar, Birgit, Tauschmann, Martin, Nagl, Katrin, Hofer, Sabine E, Campbell, Fiona, Yong, James, Hood, Korey, Lawton, Julia, Roze, Stephane, Sibayan, Judy, Bocchino, Laura, Kollman, Craig, and Hovorka, Roman
- Abstract
BACKGROUND The possible advantage of hybrid closed-loop therapy (i.e., artificial pancreas) over sensor-augmented pump therapy in very young children with type 1 diabetes is unclear. METHODS In this multicenter, randomized, crossover trial, we recruited children 1 to 7 years of age with type 1 diabetes who were receiving insulin-pump therapy at seven centers across Austria, Germany, Luxembourg, and the United Kingdom. Participants received treatment in two 16-week periods, in random order, in which the closed-loop system was compared with sensor-augmented pump therapy (control). The primary end point was the between-treatment difference in the percentage of time that the sensor glucose measurement was in the target range (70 to 180 mg per deciliter) during each 16-week period. The analysis was conducted according to the intention-to-treat principle. Key secondary end points included the percentage of time spent in a hyperglycemic state (glucose level, >180 mg per deciliter), the glycated hemoglobin level, the mean sensor glucose level, and the percentage of time spent in a hypoglycemic state (glucose level
- Published
- 2022
47. Assessing the efficacy, safety and utility of closed-loop insulin delivery compared with sensor-augmented pump therapy in very young children with type 1 diabetes (KidsAP02 study): an open-label, multicentre, multinational, randomised cross-over study protocol
- Author
-
KidsAP Consortium, Fuchs, Julia, Allen, Janet M, Boughton, Charlotte K, Wilinska, Malgorzata E, Thankamony, Ajay, de Beaufort, Carine, Campbell, Fiona, Yong, James, Fröhlich-Reiterer, Elke, Mader, Julia K, Hofer, Sabine E, Kapellen, Thomas M, Rami-Merhar, Birgit, Tauschmann, Martin, Hood, Korey, Kimbell, Barbara, Lawton, Julia, Roze, Stephane, Sibayan, Judy, Cohen, Nathan, Hovorka, Roman, Schierloh, Ulrike, Fuchs, Julia [0000-0002-4497-0979], Boughton, Charlotte K [0000-0003-3272-9544], Apollo - University of Cambridge Repository, and Clinical sciences
- Subjects
Insulin pump ,Blood Glucose ,medicine.medical_specialty ,Luxembourg ,Diabetes Mellitus, Type 1/drug therapy ,diabetes & endocrinology ,Hypoglycemic Agents/therapeutic use ,030209 endocrinology & metabolism ,paediatrics ,03 medical and health sciences ,0302 clinical medicine ,Insulin Infusion Systems ,Quality of life ,Diabetes management ,medicine ,Clinical endpoint ,Humans ,Hypoglycemic Agents ,Insulin ,Multicenter Studies as Topic ,030212 general & internal medicine ,Child ,Randomized Controlled Trials as Topic ,Protocol (science) ,Research ethics ,Type 1 diabetes ,Cross-Over Studies ,business.industry ,general diabetes ,Blood Glucose Self-Monitoring ,Infant ,General Medicine ,medicine.disease ,Crossover study ,3. Good health ,Diabetes and Endocrinology ,Diabetes Mellitus, Type 1 ,Treatment Outcome ,Insulin/therapeutic use ,Austria ,Child, Preschool ,Physical therapy ,Quality of Life ,business ,paediatric endocrinology - Abstract
IntroductionDiabetes management in very young children remains challenging. Glycaemic targets are achieved at the expense of high parental diabetes management burden and frequent hypoglycaemia, impacting quality of life for the whole family. Our objective is to assess whether automated insulin delivery can improve glycaemic control and alleviate the burden of diabetes management in this particular age group.Methods and analysisThe study adopts an open-label, multinational, multicentre, randomised, crossover design and aims to randomise 72 children aged 1–7 years with type 1 diabetes on insulin pump therapy. Following screening, participants will receive training on study insulin pump and study continuous glucose monitoring devices. Participants will be randomised to 16-week use of the hybrid closed-loop system (intervention period) or to 16-week use of sensor-augmented pump therapy (control period) with 1–4 weeks washout period before crossing over to the other arm. The order of the two study periods will be random. The primary endpoint is the between-group difference in time spent in the target glucose range from 3.9 to 10.0 mmol/L based on sensor glucose readings during the 16-week study periods. Analyses will be conducted on an intention-to-treat basis. Key secondary endpoints are between group differences in time spent above and below target glucose range, glycated haemoglobin and average sensor glucose. Participants’ and caregivers’ experiences will be evaluated using questionnaires and qualitative interviews, and sleep quality will be assessed. A health economic analysis will be performed.Ethics and disseminationEthics approval has been obtained from Cambridge East Research Ethics Committee (UK), Ethics Committees of the University of Innsbruck, the University of Vienna and the University of Graz (Austria), Ethics Committee of the Medical Faculty of the University of Leipzig (Germany) and Comité National d’Ethique de Recherche (Luxembourg). The results will be disseminated by peer-reviewed publications and conference presentations.Trial registration numberNCT03784027.
- Published
- 2021
- Full Text
- View/download PDF
48. Randomized Trial of Closed-Loop Control in Very Young Children with Type 1 Diabetes
- Author
-
Ware, Julia, primary, Allen, Janet M., additional, Boughton, Charlotte K., additional, Wilinska, Malgorzata E., additional, Hartnell, Sara, additional, Thankamony, Ajay, additional, de Beaufort, Carine, additional, Schierloh, Ulrike, additional, Fröhlich-Reiterer, Elke, additional, Mader, Julia K., additional, Kapellen, Thomas M., additional, Rami-Merhar, Birgit, additional, Tauschmann, Martin, additional, Nagl, Katrin, additional, Hofer, Sabine E., additional, Campbell, Fiona M., additional, Yong, James, additional, Hood, Korey K., additional, Lawton, Julia, additional, Roze, Stephane, additional, Sibayan, Judy, additional, Bocchino, Laura E., additional, Kollman, Craig, additional, and Hovorka, Roman, additional
- Published
- 2022
- Full Text
- View/download PDF
49. Implementation of dapagliflozin as adjunctive therapy in type 1 diabetes: a single centre real‐world experience
- Author
-
Raj, Arjun, primary, Bansiya, Vishakha, additional, Evans, Mark L, additional, and Boughton, Charlotte K, additional
- Published
- 2021
- Full Text
- View/download PDF
50. #We don't have to wait any more Closed-loop systems: transforming the landscape.
- Author
-
BOUGHTON, CHARLOTTE K. and HOVORKA, ROMAN
- Published
- 2022
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.