OBJECTIVETo evaluate the feasibility and efficacy of a fully integrated hybrid closed-loop (HCL) system (Medtronic MiniMed Inc., Northridge, CA), in day and night closedloop control in subjects with type 1 diabetes, both in an inpatient setting and during 6 days at diabetes camp. RESEARCH DESIGN AND METHODSThe Medtronic MiniMed HCL system consists of a fourth generation (4S) glucose sensor, a sensor transmitter, and an insulin pump using a modified proportionalintegral-derivative (PID) insulin feedback algorithm with safety constraints. Eight subjects were studied over 48 h in an inpatient setting. This was followed by a study of 21 subjects for 6 days at diabetes camp, randomized to either the closedloop control group using the HCL system or to the group using the Medtronic MiniMed 530G with threshold suspend (control group). RESULTSThe overall mean sensor glucose percent time in range 70-180 mg/dL was similar between the groups (73.1% vs. 69.9%, control vs. HCL, respectively) (P = 0.580).Meter glucose values between 70 and 180 mg/dL were also similar between the groups (73.6% vs. 63.2%, control vs. HCL, respectively) (P = 0.086). The mean absolute relative difference of the 4S sensor was 10.8 6 10.2%, when compared with plasma glucose values in the inpatient setting, and 12.6 6 11.0% compared with capillary Bayer CONTOUR NEXT LINK glucose meter values during 6 days at camp. CONCLUSIONSIn the first clinical study of this fully integrated system using an investigational PID algorithm, the system did not demonstrate improved glucose control compared with sensor-augmented pump therapy alone. The system demonstrated good connectivity and improved sensor performance.There have been a number of advances in developing automated insulin delivery systems for optimizing glucose control in patients with type 1 diabetes with the ultimate aim of reducing the burden of care for this condition (1-7). Early studies (8-10) demonstrated the feasibility of automated insulin modulation using

This paper presents results from an adaptive optics experiment in which an adaptive control loop augments a classical adaptive optics feedback loop. Closed-loop wavefront errors measured by a self-referencing interferometer are fed back to the control loops, which drive a membrane deformable mirror to correct the wavefront. The paper introduces new frequency-weighted deformable mirror modes used as the control channels and new wavefront sensor modes for analyzing the performance of the control loops. The corrected laser beam also is imaged by a diagnostic target camera. The experimental results show reduced closed-loop wavefront errors and correspondingly sharper diagnostic target images produced by the adaptive control loop as compared with the classical AO loop.

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