{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T11:07:29Z","timestamp":1791630449964,"version":"4.3.4"},"reference-count":26,"publisher":"American Diabetes Association","issue":"7","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"vor","delay-in-days":265,"URL":"http:\/\/www.diabetesjournals.org\/site\/license"}],"funder":[{"DOI":"10.13039\/100008871","name":"JDRF","doi-asserted-by":"publisher","award":["22-2009-799"],"award-info":[{"award-number":["22-2009-799"]}],"id":[{"id":"10.13039\/100008871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008871","name":"JDRF","doi-asserted-by":"publisher","award":["17-2013-5"],"award-info":[{"award-number":["17-2013-5"]}],"id":[{"id":"10.13039\/100008871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008871","name":"JDRF","doi-asserted-by":"publisher","award":["5-ECR-2014-112-A-N"],"award-info":[{"award-number":["5-ECR-2014-112-A-N"]}],"id":[{"id":"10.13039\/100008871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01-DK-085618"],"award-info":[{"award-number":["R01-DK-085618"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K12-DK-094714"],"award-info":[{"award-number":["K12-DK-094714"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1-TR-000142"],"award-info":[{"award-number":["UL1-TR-000142"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30-DK-45735"],"award-info":[{"award-number":["P30-DK-45735"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Closed-loop (CL) insulin delivery effectively maintains glucose overnight but struggles when challenged with meals. Use of single-day, 30-\u03bcg\/meal pramlintide lowers meal excursions during CL. We sought to further elucidate the potential benefits of adjunctive agents after 3\u20134 weeks of outpatient dose titration.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>Two CL studies were conducted: one evaluating adjunctive pramlintide and the other liraglutide. Ten subjects (age 16\u201323 years; A1C 7.2 \u00b1 0.6% [55 \u00b1 6.6 mmol\/mol]) completed two 24-h sessions: one on CL alone and one on CL plus 60-\u03bcg pramlintide (CL + P), after a 3\u20134-week outpatient dose escalation. Eleven subjects (age 18\u201327 years; A1C 7.5 \u00b1 0.9% [58 \u00b1 9.8 mmol\/mol]) were studied before and after treatment with 1.8 mg liraglutide (CL + L) after a similar 3\u20134-week dose escalation period. Timing and content of meals during CL were identical within experiments; meals were not announced.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Pramlintide delayed the time to peak plasma glucose (PG) excursion (CL 1.6 \u00b1 0.5 h vs. CL + P 2.6 \u00b1 0.9 h, P &amp;lt; 0.001) with concomitant blunting of peak postprandial increments in PG (P &amp;lt; 0.0001) and reductions in postmeal incremental PG area under the curve (AUC) (P = 0.0002). CL + L also led to reductions in PG excursions (P = 0.05) and incremental PG AUC (P = 0.004), with a 28% reduction in prandial insulin delivery. Outpatient liraglutide therapy led to a weight loss of 3.2 \u00b1 1.8 kg, with a 26% reduction in total daily insulin dose.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Adjunctive pramlintide and liraglutide treatment mitigated postprandial hyperglycemia during CL control; liraglutide demonstrated the additional benefit of weight loss in an insulin-sparing manner. Further investigations of these and other adjunctive agents in long-term outpatient CL studies are needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc16-0089","type":"journal-article","created":{"date-parts":[[2016,5,6]],"date-time":"2016-05-06T04:49:12Z","timestamp":1462510152000},"page":"1127-1134","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":92,"title":["Mitigating Meal-Related Glycemic Excursions in an Insulin-Sparing Manner During Closed-Loop Insulin Delivery: The Beneficial Effects of Adjunctive Pramlintide and Liraglutide"],"prefix":"10.2337","volume":"39","author":[{"given":"Jennifer L.","family":"Sherr","sequence":"first","affiliation":[{"name":"Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha S.","family":"Patel","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille I.","family":"Michaud","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miladys M.","family":"Palau-Collazo","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle A.","family":"Van Name","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William V.","family":"Tamborlane","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eda","family":"Cengiz","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori R.","family":"Carria","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen M.","family":"Tichy","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart A.","family":"Weinzimer","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2016,4,11]]},"reference":[{"key":"2022031301130455900_B1","doi-asserted-by":"crossref","first-page":"389","DOI":"10.2337\/diab.23.5.389","article-title":"An artificial endocrine pancreas","volume":"23","author":"Albisser","year":"1974","journal-title":"Diabetes"},{"key":"2022031301130455900_B2","doi-asserted-by":"crossref","first-page":"397","DOI":"10.2337\/diab.23.5.397","article-title":"Clinical control of diabetes by the artificial pancreas","volume":"23","author":"Albisser","year":"1974","journal-title":"Diabetes"},{"key":"2022031301130455900_B3","doi-asserted-by":"crossref","first-page":"3344","DOI":"10.2337\/db06-0419","article-title":"Feasibility of automating insulin delivery for the treatment of type 1 diabetes","volume":"55","author":"Steil","year":"2006","journal-title":"Diabetes"},{"key":"2022031301130455900_B4","doi-asserted-by":"crossref","first-page":"934","DOI":"10.2337\/dc07-1967","article-title":"Fully automated closed-loop insulin delivery versus semiautomated hybrid control in pediatric patients with type 1 diabetes using an artificial pancreas","volume":"31","author":"Weinzimer","year":"2008","journal-title":"Diabetes Care"},{"key":"2022031301130455900_B5","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/S0140-6736(09)61998-X","article-title":"Manual closed-loop insulin delivery in children and adolescents with type 1 diabetes: a phase 2 randomised crossover trial","volume":"375","author":"Hovorka","year":"2010","journal-title":"Lancet"},{"key":"2022031301130455900_B6","doi-asserted-by":"crossref","first-page":"d1855","DOI":"10.1136\/bmj.d1855","article-title":"Overnight closed loop insulin delivery (artificial pancreas) in adults with type 1 diabetes: crossover randomised controlled studies","volume":"342","author":"Hovorka","year":"2011","journal-title":"BMJ"},{"key":"2022031301130455900_B7","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1177\/193229681000400611","article-title":"Multinational study of subcutaneous model-predictive closed-loop control in type 1 diabetes mellitus: summary of the results","volume":"4","author":"Kovatchev","year":"2010","journal-title":"J Diabetes Sci Technol"},{"key":"2022031301130455900_B8","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1089\/dia.2012.0004","article-title":"Feasibility study of automated overnight closed-loop glucose control under MD-logic artificial pancreas in patients with type 1 diabetes: the DREAM Project","volume":"14","author":"Nimri","year":"2012","journal-title":"Diabetes Technol Ther"},{"key":"2022031301130455900_B9","first-page":"159","article-title":"The \u201cGlucositter\u201d overnight automated closed loop system for type 1 diabetes: a randomized crossover trial","volume":"14","author":"Nimri","year":"2013","journal-title":"Pediatr Diabetes"},{"key":"2022031301130455900_B10","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.2337\/dc12-0071","article-title":"Blood glucose control in type 1 diabetes with a bihormonal bionic endocrine pancreas","volume":"35","author":"Russell","year":"2012","journal-title":"Diabetes Care"},{"key":"2022031301130455900_B11","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.2337\/dc09-2254","article-title":"Novel use of glucagon in a closed-loop system for prevention of hypoglycemia in type 1 diabetes","volume":"33","author":"Castle","year":"2010","journal-title":"Diabetes Care"},{"key":"2022031301130455900_B12","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1503\/cmaj.121265","article-title":"Glucose-responsive insulin and glucagon delivery (dual-hormone artificial pancreas) in adults with type 1 diabetes: a randomized crossover controlled trial","volume":"185","author":"Haidar","year":"2013","journal-title":"CMAJ"},{"key":"2022031301130455900_B13","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1177\/193229681200600516","article-title":"Feasibility of a bihormonal closed-loop system to control postexercise and postprandial glucose excursions","volume":"6","author":"Van Bon","year":"2012","journal-title":"J Diabetes Sci Technol"},{"key":"2022031301130455900_B14","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.2337\/dc15-2344","article-title":"Randomized crossover comparison of personalized MPC and PID control algorithms for the artificial pancreas","volume":"39","author":"Pinsker","year":"2016","journal-title":"Diabetes Care"},{"key":"2022031301130455900_B15","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.2337\/dc15-2468","article-title":"Multinational home use of closed-loop control is safe and effective","volume":"39","author":"Anderson","year":"2016","journal-title":"Diabetes Care"},{"key":"2022031301130455900_B16","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.2337\/dc16-0008","article-title":"Day-and-night closed-loop glucose control in patients with type I diabetes under free-living conditions: results of a single-arm 1-month experience compared with a previously reported feasibility study of evening and night at home","volume":"39","author":"Renard","year":"2016","journal-title":"Diabetes Care"},{"key":"2022031301130455900_B17","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.2337\/dc15-2078","article-title":"Day-and-night hybrid closed-loop insulin delivery in adolescents with type 1 diabetes: a free-living, randomized clinical trial","volume":"39","author":"Tauschmann","year":"2016","journal-title":"Diabetes Care"},{"key":"2022031301130455900_B18","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.2337\/dc15-2815","article-title":"Randomized summer camp crossover trial in 5- to 9-year-old children: outpatient wearable artificial pancreas is feasible and safe","volume":"39","author":"Del Favero","year":"2016","journal-title":"Diabetes Care"},{"key":"2022031301130455900_B19","doi-asserted-by":"crossref","first-page":"1994","DOI":"10.2337\/dc12-0330","article-title":"Effect of pramlintide on prandial glycemic excursions during closed-loop control in adolescents and young adults with type 1 diabetes","volume":"35","author":"Weinzimer","year":"2012","journal-title":"Diabetes Care"},{"key":"2022031301130455900_B20","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s001250051165","article-title":"Is glucagon-like peptide 1 an incretin hormone","volume":"42","author":"Nauck","year":"1999","journal-title":"Diabetologia"},{"key":"2022031301130455900_B21","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1210\/jc.2010-2578","article-title":"The effect of insulin feedback on closed loop glucose control","volume":"96","author":"Steil","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"2022031301130455900_B22","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.cmpb.2010.06.007","article-title":"Physiologic insulin delivery with insulin feedback: a control systems perspective","volume":"102","author":"Palerm","year":"2011","journal-title":"Comput Methods Programs Biomed"},{"key":"2022031301130455900_B23","doi-asserted-by":"crossref","first-page":"4679","DOI":"10.1210\/jc.2009-0921","article-title":"Preserved inhibitory potency of GLP-1 on glucagon secretion in type 2 diabetes mellitus","volume":"94","author":"Hare","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"key":"2022031301130455900_B24","doi-asserted-by":"crossref","first-page":"3702","DOI":"10.1210\/jc.2015-2725","article-title":"The impact of chronic liraglutide therapy on glucagon secretion in type 2 diabetes: insight from the LIBRA trial","volume":"100","author":"Kramer","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"key":"2022031301130455900_B25","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.metabol.2013.10.002","article-title":"Type 1 diabetes, metabolic syndrome and cardiovascular risk","volume":"63","author":"Chillar\u00f3n","year":"2014","journal-title":"Metabolism"},{"key":"2022031301130455900_B26","article-title":"Effect of metformin added to insulin on glycemic control among overweight\/obese adolescents with type 1 diabetes: a randomized clinical trial","author":"Libman","journal-title":"JAMA"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/care.diabetesjournals.org\/syndication\/doi\/10.2337\/dc16-0089","content-type":"unspecified","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/39\/7\/1127\/626584\/dc160089.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/39\/7\/1127\/626584\/dc160089.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T04:54:32Z","timestamp":1647147272000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/39\/7\/1127\/37359\/Mitigating-Meal-Related-Glycemic-Excursions-in-an"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,4,11]]},"references-count":26,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2016,4,11]]},"published-print":{"date-parts":[[2016,7,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc16-0089","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,4,11]]}}}