In people with type 1 diabetes, can an artificial pancreas algorithm improve postprandial glycaemic control following an unannounced meal compared with traditional carbohydrate counting?

The Hunter New England Diabetes Research Network (HNEHRN) has developed a novel artificial pancreas algorithm with multiple future food and exercise scenarios called scenario based moving horizon stochastic dynamic programming (SCENIC). SCENIC will allow the integration of multiple inputs, learnt responses and patterning data so the system can cope with events such as food and exercise without hypoglycaemia. This study will determine if SCENIC is capable of maintaining glycaemic control during a meal. Participants will attend the Hunter Medical Research Institute for 5 consecutive evenings at 4pm, having fasted and not adjusted their insulin since 1pm. Participants will have their blood glucose levels monitored using capillary blood sampling and a glucometer at 15 min intervals from 4-5pm. At 5pm, participants will be given the standardised test meal and their blood glucose levels will continue to be monitored at 15 min intervals until 9pm. On the first night, no mealtime insulin dose will be administered. On the second night, the usual mealtime insulin bolus will be administered according the the participant's usual clinical care. On nights 3-5, the insulin dose will be determined using SCENIC. In the event of hypoglycaemia prior to the session, the session will be rescheduled. In the event of hypoglycaemia during a session, the session will be terminated and the participant treated according to their routine clinical care.