Predictive Low-Glucose Suspend Reduces Hypoglycemia in Adults, Adolescents, and Children With Type 1 Diabetes in an At-Home Randomized Crossover Study: Results of the PROLOG Trial.

OBJECTIVE: This study evaluated a new insulin delivery system designed to reduce insulin delivery when trends in continuous glucose monitoring (CGM) glucose concentrations predict future hypoglycemia. RESEARCH DESIGN AND METHODS: Individuals with type 1 diabetes (n = 103, age 6-72 years, mean HbA1c 7.3% [56 mmol/mol]) participated in a 6-week randomized crossover trial to evaluate the efficacy and safety of a Tandem Diabetes Care t:slim X2 pump with Basal-IQ integrated with a Dexcom G5 sensor and a predictive low-glucose suspend algorithm (PLGS) compared with sensor-augmented pump (SAP) therapy. The primary outcome was CGM-measured time <70 mg/dL. RESULTS: Both study periods were completed by 99% of participants; median CGM usage exceeded 90% in both arms. Median time <70 mg/dL was reduced from 3.6% at baseline to 2.6% during the 3-week period in the PLGS arm compared with 3.2% in the SAP arm (difference [PLGS - SAP] = -0.8%, 95% CI -1.1 to -0.5, P < 0.001). The corresponding mean values were 4.4%, 3.1%, and 4.5%, respectively, represent-ing a 31% reduction in the time <70 mg/dL with PLGS. There was no increase in mean glucose concentration (159 vs. 159 mg/dL, P = 0.40) or percentage of time spent >180 mg/dL (32% vs. 33%, P = 0.12). One severe hypoglycemic event occurred in the SAP arm and none in the PLGS arm. Mean pump suspension time was 104 min/day. CONCLUSIONS: The Tandem Diabetes Care Basal-IQ PLGS system significantly reduced hypoglycemia without rebound hyperglycemia, indicating that the system can benefit adults and youth with type 1 diabetes in improving glycemic control.

Estimation of the distribution of Tabebuia guayacan (Bignoniaceae) using high-resolution remote sensing imagery.

Species identification and characterization in tropical environments is an emerging field in tropical remote sensing. Significant efforts are currently aimed at the detection of tree species, of levels of forest successional stages, and the extent of liana occurrence at the top of canopies. In this paper we describe our use of high resolution imagery from the Quickbird Satellite to estimate the flowering population of Tabebuia guayacan trees at Barro Colorado Island (BCI), in Panama. The imagery was acquired on 29 April 2002 and 21 March 2004. Spectral Angle Mapping via a One-Class Support Vector machine was used to detect the presence of 422 and 557 flowering tress in the April 2002 and March 2004 imagery. Of these, 273 flowering trees are common to both dates. This study presents a new perspective on the effectiveness of high resolution remote sensing for monitoring a phenological response and its use as a tool for potential conservation and management of natural resources in tropical environments.