Closed-Loop System Improves Glycemic Control in Young Children With T1DM

Percentage of time with glucose level in target range higher during closed-loop period versus sensor-augmented pump therapy period

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FRIDAY, Jan. 21, 2022 (HealthDay News) -- Compared with sensor-augmented pump therapy, a hybrid closed-loop system improves glycemic control in young children with type 1 diabetes, according to a study published in the Jan. 20 issue of the New England Journal of Medicine.

Julia Ware, M.D., from the University of Cambridge in the United Kingdom, and colleagues recruited 74 children aged 1 to 7 years with type 1 diabetes who were receiving insulin-pump therapy for a multicenter, randomized, crossover trial. Participants received treatment in two 16-week periods in random order, comparing the closed-loop system to sensor-augmented pump therapy (control).

The researchers found that the percentage of time with the glucose level in the target range (70 to 180 mg/dL) was 8.7 percentage points higher during the closed-loop versus the control period. The mean adjusted difference in the percentage of time spent in a hyperglycemic state was −8.5 percentage points for closed-loop minus control; the difference in the glycated hemoglobin level was −0.4 percentage points; and the difference in mean sensor glucose level was −12.3 mg/dL. The two treatments yielded a similar time spent in the hypoglycemic state. During the 16-week closed-loop period, the median time spent in the closed-loop mode was 95 percent. During the closed-loop period, there was one serious adverse event of severe hypoglycemia.

"The trial by Ware et al. offers hope that major problematic areas of diabetes management in young children can be resolved with appropriate technology," writes the author of an accompanying editorial.

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