Citations 1
Closed-Loop Insulin Therapy Improves Glycemic Control in Adolescents and Young Adults: Outcomes from the International Diabetes Closed-Loop Trial
Isganaitis, Elvira , Raghinaru, Dan, Ambler-Osborn, Louise, Pinsker, Jordan E. , Buckingham, Bruce A. , Ekhlaspour, Laya , Kudva, Yogish C., Forlenza, Gregory P. , Beck, Roy W., Kollman, Craig, Lum, John W. , Brown, Sue A. , Laffel, Lori M. , Kovatchev, Boris, Anderson, Stacey, Emory, Emma, Voelmle, Mary, Conshafter, Katie, Morris, Kim, Gondor-Fredrick, Linda, Mitchell, Harry, Calvo, Kayla, Wakeman, Christian, Breton, Marc, Flint, Emily, Kim, Kenny, Roethke, Lindsay, Church, Mei Mei , André, Camille , Piper, Molly, Lam, David , O’Malley, Grenye , Levister, Camilla, Ogyaadu, Selassie, Lovett, Jessica, Simha, Vinaya , Dadlani, Vikash, McCrady-Spitzer, Shelly , Reid, Corey, Alonso, G. Todd, Slover, Robert H., Jost, Emily , Berget, Cari, Towers, Lindsey, Rossick-Solis, Alex, Jacobson, Tali, Town, Marissa, Tabatabai, Ideen , Keller, Jordan, Salas, Evalina, Dassau, Eyal , Passman, Samantha, Campos, Tiffany, Murphy, Carlos, Patibandla, Nandan, Borgman, Sarah, Arreaza-Rubín, Guillermo , Green, Neal, Laffel, Lori, Pinsker, Jordan, Doyle, Francis, Renard, Eric, Reznik, Yves , Lum, John, Janicek, Robert, Gabrielson, Deanna, Belle, Steven H., Castle, Jessica R. , Green, Jennifer , Legault, Laurent , Wysham, Carol , Eggerman, Thomas, Forlenza, Gregory P , Buckingham, Bruce , Wadwa, R Paul , Kudva, Yogish C. , Levy, Carol J. , Kollman, Craig , Kovatchev, Boris , Anderson, Stacey M. , Oliveri, Mary Clancy , Kumari, Kanchan , Messer, Laurel H , Jacobson, Tali, Doyle, Francis J. , Patibandla, Nandan, Laffel, Lori M. , Cobelli, Claudio , Beck, Roy W. , Willi, Steven Matthew
Diabetes Technology & Therapeutics | November 20, 2020 | Volume: 23 | Issue: 5 | Pages: 342-349
Objective: To assess the efficacy and safety of closed-loop control (CLC) insulin delivery system in adolescents and young adults with type 1 diabetes. Research Design and Methods: Prespecified subanalysis of outcomes in adolescents and young adults aged 14–24 years old with type 1 diabetes in a previously published 6-month multicenter randomized trial. Participants were randomly assigned 2:1 to CLC (Tandem Control-IQ) or sensor augmented pump (SAP, various pumps+Dexcom G6 CGM) and followed for 6 months. Results: Mean age of the 63 participants was 17 years, median type 1 diabetes duration was 7 years, and mean baseline HbA1c was 8.1%. All 63 completed the trial. Time in range (TIR) increased by 13% with CLC versus decreasing by 1% with SAP (adjusted treatment group difference = +13% [+3.1 h/day]; 95% confidence interval [CI] 9–16, P < 0.001), which largely reflected a reduction in time >180 mg/dL (adjusted difference −12% [−2.9 h/day], P < 0.001). Time <70 mg/dL decreased by 1.6% with CLC versus 0.3% with SAP (adjusted difference −0.7% [−10 min/day], 95% CI −1.0% to −0.2%, P = 0.002). CLC use averaged 89% of the time for 6 months. The mean adjusted difference in HbA1c after 6 months was 0.30% in CLC versus SAP (95% CI −0.67 to +0.08, P = 0.13). There was one diabetic ketoacidosis episode in the CLC group. Conclusions: CLC use for 6 months was substantial and associated with improved TIR and reduced hypoglycemia in adolescents and young adults with type 1 diabetes. Thus, CLC has the potential to improve glycemic outcomes in this challenging age group. The clinical trial was registered with ClinicalTrials.gov (NCT03563313).