First year on commercial hybrid closed-loop system - experience on 111 children and adolescents with type 1 diabetes

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Varimo , T , Pulkkinen , M-A , Hakonen , E , Hero , M , Miettinen , P J & Tuomaala , A-K 2021 , ' First year on commercial hybrid closed-loop system - experience on 111 children and adolescents with type 1 diabetes ' , Pediatric Diabetes , vol. 22 , no. 6 , pp. 909-915 . https://doi.org/10.1111/pedi.13235

Title: First year on commercial hybrid closed-loop system - experience on 111 children and adolescents with type 1 diabetes
Author: Varimo, Tero; Pulkkinen, Mari-Anne; Hakonen, Elina; Hero, Matti; Miettinen, Päivi J; Tuomaala, Anna-Kaisa
Contributor organization: HUS Children and Adolescents
Children's Hospital
University of Helsinki
Helsinki University Hospital Area
Raivio Group
Clinicum
Centre of Excellence in Stem Cell Metabolism
Timo Pyry Juhani Otonkoski / Principal Investigator
Research Programs Unit
Date: 2021-09
Language: eng
Number of pages: 7
Belongs to series: Pediatric Diabetes
ISSN: 1399-543X
DOI: https://doi.org/10.1111/pedi.13235
URI: http://hdl.handle.net/10138/340441
Abstract: Objective The hybrid close-loop system (HCL) is a rapidly emerging treatment method for type 1 diabetes (T1D), but the long-term effectiveness of the system remains unclear. This study investigates the influence of the HCL on glycemic control in children and adolescents with T1D in a real-life setting during the first year on HCL. Research design and methods This retrospective study included all the patients (n = 111) aged 3 to 16 years with T1D who initiated the HCL system between 1st of December 2018 and 1st of December 2019 in the Helsinki University Hospital. Time in range (TIR), HbA1c, mean sensor glucose (SG) value, time below range (TBR), and SG coefficient of variance (CV) were measured at 0, 1, 3, 6, and 12 month. The changes over time were analyzed with a repeated mixed model adjusted with baseline glycemic control. Results After the initiation of HCL, all measures of glycemic control, except HbA1c, improved and the effect lasted throughout the study period. Between 0 and 12 month, TIR increased (beta = -2.5 [95%CI: -3.6 - (-1.3)], p < 0.001), whereas mean SG values (beta = -0.7 [95%CI: -0.9 - (-0.4)]), TBR (beta = -2.5 [95%CI: -3.6 - (-1.3)]), and SG CV (beta = -4.5 [95%CI: -6.3 - [-2.8]) decreased significantly (p < 0.001). Importantly, the changes occurred regardless of the age of the patient. Conclusions Measurements of glycemic control, except HbA1c, improved significantly after the initiation of the HCL system and the favorable effect lasted throughout the follow-up. These results support the view that HCL is an efficacious treatment modality for children and adolescents with T1D of all ages.
Subject: LIFE
MICROVASCULAR COMPLICATIONS
THERAPY
glycemic control
hybrid closed-loop system
type 1 diabetes
3123 Gynaecology and paediatrics
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Rights: cc_by_nc
Usage restriction: openAccess
Self-archived version: publishedVersion


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