To remember
- A prospective study of 3 months shows that a closed loop system improves glycemic control in young type 1 diabetics (T1D) who are insufficiently controlled.
- Time spent in target HbA1c was increased by almost 40%.
Why is this important?
Some young people with T1D are at high risk for poor adherence to treatment and suboptimal glycemic control. However, glycemic control at this period of life is predictive of the long-term evolution of HbA1c. The closed-loop system can be an interesting solution for these subjects. This study has the advantage of having evaluated the system in young people aged 13 to 25, whereas until now only one study had reported the effectiveness of this system in young people aged 7 to 17.
Methodology
This prospective study was conducted over a period of 3 months including 20 young type 1 diabetics aged 13 to 25 (HbA1c ≥8.5%) receiving daily multiple injections and followed up in 2 healthcare centres. A closed loop system with Minimed 780G pump was used.
Principle results
The mean age of the included population was 18.8 years (60% girls, mean body mass index (BMI) at inclusion 25.2 g/m2).
At the end of the 3-month study period, the average HbA1c had fallen from 10.5% (±2.1%) to 7.6% (±1.1%), i.e. an average drop of 2 .9%. The average dose of insulin administered was 72 IU, of which 47% basal and 53% self-corrected. The time spent within the target set between 0.70 and 1.80 g/L increased from 27.6% to 66.5%, thus increasing in 3 months by 38.9%. Other parameters were also improved, such as blood sugar variability.
Two episodes of moderate to mild ketoacidosis were reported (attributed to infusion failure).
Principales limitations
This study was conducted on a small population.