Usage and Effectiveness of the Low Glucose Suspend Feature of the Medtronic Paradigm Veo Insulin Pump

Agrawal, Pratik; Welsh, John; Kannard, Brian; Askari, Sina; Yang, Qingqing; Kaufman, Francine

doi:10.1177/193229681100500514

Cited by 80 publications

(63 citation statements)

References 7 publications

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“…[7][8][9] In studies of sensor-augmented pumps with a low glucose suspend feature (Paradigm VeoÔ; Medtronic Diabetes), no significant ketosis or ketoacidosis has been reported in thousands of 2-h nocturnal pump suspensions. [10][11][12][13] On intervention nights (algorithm operational), glucose levels tended to be lower on nights with pump suspension compared with nights without pump suspension, reflecting that there were lower glucose levels on nights triggering a suspension. However, not unexpectedly, when comparing all intervention nights (with and without pump suspension) with control nights, mean overnight glucose and morning fasting glucose levels tended to be higher on the intervention nights.…”

Section: Discussionmentioning

confidence: 99%

Outpatient Safety Assessment of an In-Home Predictive Low-Glucose Suspend System with Type 1 Diabetes Subjects at Elevated Risk of Nocturnal Hypoglycemia

Buckingham

Cameron

Calhoun

et al. 2013

Diabetes Technology & Therapeutics

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Objective: Nocturnal hypoglycemia is a common problem with type 1 diabetes. In the home setting, we conducted a pilot study to evaluate the safety of a system consisting of an insulin pump and continuous glucose monitor communicating wirelessly with a bedside computer running an algorithm that temporarily suspends insulin delivery when hypoglycemia is predicted. Research Design and Methods: After the run-in phase, a 21-night randomized trial was conducted in which each night was randomly assigned 2:1 to have either the predictive low-glucose suspend (PLGS) system active (intervention night) or inactive (control night). Three predictive algorithm versions were studied sequentially during the study for a total of 252 intervention and 123 control nights. The trial included 19 participants 18-56 years old with type 1 diabetes (hemoglobin A1c level of 6.0-7.7%) who were current users of the MiniMed Paradigm Ò REAL-Time RevelÔ System and Sof-sensor Ò glucose sensor (Medtronic Diabetes, Northridge, CA). Results: With the final algorithm, pump suspension occurred on 53% of 77 intervention nights. Mean morning glucose level was 144 -48 mg/dL on the 77 intervention nights versus 133 -57 mg/dL on the 37 control nights, with morning blood ketones >0.6 mmol/L following one intervention night. Overnight hypoglycemia was lower on intervention than control nights, with at least one value £70 mg/dL occurring on 16% versus 30% of nights, respectively, with the final algorithm. Conclusions: This study demonstrated that the PLGS system in the home setting is safe and feasible. The preliminary efficacy data appear promising with the final algorithm reducing nocturnal hypoglycemia by almost 50%.

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Section: Discussionmentioning

confidence: 99%

Outpatient Safety Assessment of an In-Home Predictive Low-Glucose Suspend System with Type 1 Diabetes Subjects at Elevated Risk of Nocturnal Hypoglycemia

Buckingham

Cameron

Calhoun

et al. 2013

Diabetes Technology & Therapeutics

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“…This system contains hypoglycemic alarms for predicted and threshold levels of hypoglycemia but no remote telemedicine capabilities. 26 A remote warning system for use by CGM device users who might be experiencing unrecognized nocturnal hypoglycemia was approved by the FDA. The system consists of a monitor for the patient, a power supply, and a transmitter to send information to a second monitor at the bedside of another person in the house.…”

Section: Closed-loop Systemsmentioning

confidence: 99%

Improved Outcomes from Diabetes Monitoring: The Benefits of Better Adherence, Therapy Adjustments, Patient Education, and Telemedicine Support

Klonoff

2012

J Diabetes Sci Technol

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“…To date, there has been little evaluation of the efficacy and safety of this function in the prevention of severe hypoglycaemias [37,38].…”

Section: Hypoglycaemia and Glucose Variabilitymentioning

confidence: 99%

Real-time continuous glucose monitoring (CGM) integrated into the treatment of type 1 diabetes: Consensus of experts from SFD, EVADIAC and SFE

Benhamou

Catargi

Delenne³

et al. 2012

Diabetes & Metabolism

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Usage and Effectiveness of the Low Glucose Suspend Feature of the Medtronic Paradigm Veo Insulin Pump

Abstract: The LGS feature was on for most of the patient days in the study. Most LGS episodes lasted for <10 min. Use of the LGS feature significantly reduced exposure to hypoglycemia. Profound hyperglycemia resulting from LGS episodes lasting >115 min was not observed.

Cited by 80 publications

References 7 publications

Outpatient Safety Assessment of an In-Home Predictive Low-Glucose Suspend System with Type 1 Diabetes Subjects at Elevated Risk of Nocturnal Hypoglycemia

Outpatient Safety Assessment of an In-Home Predictive Low-Glucose Suspend System with Type 1 Diabetes Subjects at Elevated Risk of Nocturnal Hypoglycemia

Improved Outcomes from Diabetes Monitoring: The Benefits of Better Adherence, Therapy Adjustments, Patient Education, and Telemedicine Support

Real-time continuous glucose monitoring (CGM) integrated into the treatment of type 1 diabetes: Consensus of experts from SFD, EVADIAC and SFE

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