Closed-Loop Insulin Therapy Improves Glycemic Control in Adolescents and Young Adults: Outcomes from the International Diabetes Closed-Loop Trial.

Diabetes Technology & Therapeutics
Elvira IsganaitisiDCL Trial Research Group

Abstract

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...Continue Reading

References

Sep 30, 1993·The New England Journal of Medicine·UNKNOWN Diabetes Control and Complications Trial Research GroupC Siebert
Sep 10, 2008·The New England Journal of Medicine·William V TamborlaneDongyuan Xing
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Feb 11, 2016·Diabetes Care·UNKNOWN Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Study Resear
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Citations

Jun 15, 2021·Diabetes Research and Clinical Practice·Virginia BellidoFrancisco Javier Ampudia-Blasco
Sep 16, 2021·Diabetes Technology & Therapeutics·Tara KaushalLori Laffel
Oct 6, 2021·Diabetes Technology & Therapeutics·Elena ToschiMedha Munshi
Oct 12, 2021·JAMA Pediatrics·Mary B AbrahamUNKNOWN Australian Juvenile Diabetes Research Fund Closed-Loop Research group

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Software Mentioned

- IQ
Control
SAS
SAP
CLC

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