A Meal Detection Algorithm for the Artificial Pancreas: A Randomized Controlled Clinical Trial in Adolescents With Type 1 Diabetes
Methods: We conducted a randomized crossover trial in 11 adolescents aged 12-18 years with HbA1c≥7.5% who missed≥1 bolus in the past six months. We compared (i) CSII, (ii) artificial pancreas (AP), and (iii) artificial pancreas with a meal detection algorithm (AP+MDA). Participants underwent three 9-hour interventions involving breakfast with a bolus and lunch without a bolus.
Results: In AP+MDA, the meal detection time was 40.0 [40.0–57.5] minutes. Compared to CSII, AP+MDA decreased the 4-hour post-lunch iAUC from 24.1±9.5 h.mmol/L to 15.4±8.0 h.mmol/L (p=0.03). iAUC did not differ between AP+MDA and AP (19.6±10.4 h.mmol/L, p=0.21) nor between AP and CSII (p=0.33). The AP+MDA reduced time>10mmol/L (58.0±26.6%) compared to CSII (79.6±27.5%, p=0.02) and AP (74.2±20.6%, p=0.047).
Conclusions: The AP+MDA improved glucose control after an unannounced meal.