PLGS systems have been demonstrated to limit hypoglycemia. Reduced insulin during suspensions may avoid the need for rescue CHO or lessen the amount of CHO needed. The approximately 20-hour inpatient evaluation of the Lilly investigational AID system’s PLGS feature, including a basal up-titration period to activate the PLGS and investigator-directed administration of rescue CHO, allowed assessment of hypoglycemia prevention and treatment requirements. Ten subjects with type 1 diabetes (40% male, mean age 39.0±13.0 years, A1C 7.2±0.6%, and insulin usage 0.6±0.2 U/kg/day) were studied. There were 59 suspensions, with all subjects experiencing suspensions during which CHO were not administered. Only six suspensions were associated with rescue CHO and five suspensions were associated with hypoglycemia (CGM glucose <70 mg/dL for ≥15 minutes), see Table. No rescue CHO were given during or after insulin suspension for the overnight basal up-titration. Rescue CHO consisted of median 9g CHO (range: 5-16g). No episode required repeat CHO administration. New hypoglycemia treatment guidelines for PLGS users should reflect that PLGS reduces CHO requirements for hypoglycemia rescue. This guidance will be important to minimize rebound hyperglycemia and needless calorie intake from hypoglycemia over-treatment.

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Disclosure

J.E. Pinsker: Advisory Panel; Self; Medtronic. Consultant; Self; Eli Lilly and Company, Tandem Diabetes Care. Research Support; Self; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Medtronic, Tandem Diabetes Care. Speaker’s Bureau; Self; Tandem Diabetes Care. A. Bartee: None. M. Katz: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. A. LaLonde: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. R. Jones: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. E. Dassau: Consultant; Self; Eli Lilly and Company. Research Support; Self; Dexcom, Inc., DreaMed Diabetes, Tandem Diabetes Care, Xeris Pharmaceuticals, Inc. Speaker’s Bureau; Self; Roche Diabetes Care. Other Relationship; Self; Dexcom, Inc., Insulet Corporation, Roche Diabetes Care. H. Wolpert: Employee; Self; Eli Lilly and Company.

© 2020 by the American Diabetes Association
2020
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