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Day-and-Night Closed-Loop Insulin Delivery in a Broad Population of Pregnant Women With Type 1 Diabetes: A Randomized Controlled Crossover Trial

Overview of attention for article published in Diabetes Care, March 2018
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (90th percentile)
  • Above-average Attention Score compared to outputs of the same age and source (61st percentile)

Citations

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30 Mendeley
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Title
Day-and-Night Closed-Loop Insulin Delivery in a Broad Population of Pregnant Women With Type 1 Diabetes: A Randomized Controlled Crossover Trial
Published in
Diabetes Care, March 2018
DOI 10.2337/dc17-2534
Pubmed ID
Authors

Zoe A. Stewart, Malgorzata E. Wilinska, Sara Hartnell, Leanne K. O’Neil, Gerry Rayman, Eleanor M. Scott, Katharine Barnard, Conor Farrington, Roman Hovorka, Helen R. Murphy

Abstract

Despite advances in technology, optimal glucose control remains elusive and neonatal complications ubiquitous in type 1 diabetes (T1D) pregnancy. Our aim was to examine the safety, efficacy, and longer-term feasibility of day-and-night closed-loop insulin delivery. We recruited 16 pregnant women (mean [SD]: age 32.8 [5.0] years, T1D duration 19.4 [10.2] years, HbA1c8.0% [1.1%], BMI 26.6 [4.4] kg/m2) to an open-label, randomized, crossover trial. Participants completed 28 days of closed-loop and sensor-augmented pump (SAP) insulin delivery separated by a washout period. Afterward, participants could continue to use the closed-loop system up to 6 weeks postpartum. The primary end point was the proportion of time with glucose levels within the target range (63-140 mg/dL). The proportion of time with glucose levels within target was comparable during closed-loop and SAP insulin delivery (62.3 vs. 60.1% [95% CI -4.1 to 8.3%];P= 0.47). Mean glucose and time spent hyperglycemic >140 mg/dL also did not differ (131.4 vs. 131.4 mg/dL [P= 0.85] and 36.6 vs. 36.1% [P= 0.86], respectively). During closed-loop, fewer hypoglycemic episodes occurred (median [range] 8 [1-17] vs. 12.5 [1-53] over 28 days;P= 0.04) and less time at <63 mg/dL (1.6 vs. 2.7%;P= 0.02). Hypoglycemia <50 mg/dL (0.24 vs. 0.47%;P= 0.03) and low blood glucose index (1.0 vs. 1.4;P= 0.01) were lower. Less nocturnal hypoglycemia (2300-0700 h) during closed-loop therapy (1.1 vs. 2.7%;P= 0.008) and a trend toward higher overnight time in target (67.7 vs. 60.6%;P= 0.06) were found. Closed-loop insulin delivery was associated with comparable glucose control and significantly less hypoglycemia than SAP therapy. Larger, longer duration multicenter trials are now indicated to determine clinical efficacy of closed-loop insulin delivery in T1D pregnancy and the impact on neonatal outcomes.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 30 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 30 100%

Demographic breakdown

Readers by professional status Count As %
Unspecified 7 23%
Student > Bachelor 6 20%
Other 4 13%
Researcher 4 13%
Student > Ph. D. Student 3 10%
Other 6 20%
Readers by discipline Count As %
Medicine and Dentistry 12 40%
Unspecified 9 30%
Biochemistry, Genetics and Molecular Biology 3 10%
Engineering 3 10%
Immunology and Microbiology 1 3%
Other 2 7%

Attention Score in Context

This research output has an Altmetric Attention Score of 24. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 April 2019.
All research outputs
#704,746
of 13,644,952 outputs
Outputs from Diabetes Care
#1,210
of 7,789 outputs
Outputs of similar age
#26,559
of 272,407 outputs
Outputs of similar age from Diabetes Care
#53
of 139 outputs
Altmetric has tracked 13,644,952 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 7,789 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 19.0. This one has done well, scoring higher than 84% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 272,407 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 90% of its contemporaries.
We're also able to compare this research output to 139 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 61% of its contemporaries.