The automatic "threshold suspend" (TS) feature of an insulin pump helps prevent life-threatening hypoglycemic events when the device's sensor detects blood glucose concentrations below the preset threshold. However, in individuals with type 1 diabetes who have had previous episodes of hypoglycemia the TS feature may be less effective at preventing subsequent events, according to important new results from the ASPIRE study published in Diabetes Technology & Therapeutics (DTT), a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The article is available on the DTT website.
In the article "Hypoglycemia Begets Hypoglycemia: The Order Effect in the ASPIRE In-Clinic Study," Editor-in-Chief of Diabetes Technology & Therapeutics Satish Garg, MD (Professor of Medicine and Pediatrics at the University of Colorado Denver) and coauthors compared the effects of an automatic insulin pump with TS at a preset sensor threshold to those of continued basal insulin delivery in adults with type 1 diabetes following induced hypoglycemia via overnight fasting and exercise.
The different outcomes seen between the two insulin delivery methods in this crossover study design led the authors to conclude that "By mitigating the duration of hypoglycemic episodes, automatic pump suspension may help to preserve the normal autonomic response to hypoglycemia in patients with type 1 diabetes."