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

Elvira Isganaitis | Zendy; Dan Raghinaru | Zendy; Louise Ambler-Osborn | Zendy; Jordan E. Pinsker | Zendy; Bruce A. Buckingham | Zendy; R. Paul Wadwa | Zendy; Laya Ekhlaspour | Zendy; Yogish C. Kudva | Zendy; Carol J. Levy | Zendy; Gregory P. Forlenza | Zendy; Roy W. Beck | Zendy; Craig Kollman | Zendy; John Lum | Zendy; Sue A. Brown | Zendy; Lori M. Laffel | Zendy; Boris Kovatchev | Zendy; Stacey Anderson | Zendy; Emma Emory | Zendy; Mary Voelmle | Zendy; Katie Conshafter | Zendy; Kim Morris | Zendy; Mary C. Oliveri | Zendy; Linda Gondor-Fredrick | Zendy; Harry Mitchell | Zendy; Kayla Calvo | Zendy; Christian Wakeman | Zendy; Marc Breton | Zendy; Emily Flint | Zendy; Kenny Kim | Zendy; Lindsay Roethke | Zendy; Mei Mei Church | Zendy; Camille André | Zendy; Molly Piper | Zendy; David Lam | Zendy; Grenye O’Malley | Zendy; Camilla Levister | Zendy; Selassie Ogyaadu | Zendy; Jessica Lovett | Zendy; Vinaya Simha | Zendy; Vikash Dadlani | Zendy; Shelly McCrady-Spitzer | Zendy; Corey Reid | Zendy; Kanchan Kumari | Zendy; G. Todd Alonso | Zendy; Robert H. Slover | Zendy; Emily Jost | Zendy; Laurel H. Messer | Zendy; Cari Berget | Zendy; Lindsey Towers | Zendy; Alex Rossick-Solis | Zendy; Tali Jacobson | Zendy; Marissa Town | Zendy; Ideen Tabatabai | Zendy; Jordan Keller | Zendy; Evalina Salas | Zendy; Francis J. Doyle | Zendy; Eyal Dassau | Zendy; Samantha Passman | Zendy; Tiffany Campos | Zendy; Carlos Murphy | Zendy; Nandan Patibandla | Zendy; Sarah Borgman | Zendy; Guillermo Arreaza-Rubín | Zendy; Neal Green | Zendy; Lori Laffel | Zendy; Jordan Pinsker | Zendy; Francis Doyle | Zendy; Eric Renard | Zendy; Claudio Cobelli | Zendy; Yves Reznik | Zendy; Robert Janicek | Zendy; Deanna Gabrielson | Zendy; Steven H. Belle | Zendy; Jessica R. Castle | Zendy; Jennifer Green | Zendy; Laurent Legault | Zendy; Steven M. Willi | Zendy; Carol Wysham | Zendy; Thomas Eggerman | Zendy

Open Access

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

Author(s) -

Elvira Isganaitis,

Dan Raghinaru,

Louise Ambler-Osborn,

Jordan E. Pinsker,

Bruce A. Buckingham,

R. Paul Wadwa,

Laya Ekhlaspour,

Yogish C. Kudva,

Carol J. Levy,

Gregory P. Forlenza,

Roy W. Beck,

Craig Kollman,

John Lum,

Sue A. Brown,

Lori M. Laffel,

Boris Kovatchev,

Stacey Anderson,

Emma Emory,

Mary Voelmle,

Katie Conshafter,

Kim Morris,

Mary C. Oliveri,

Linda Gondor-Fredrick,

Harry Mitchell,

Kayla Calvo,

Christian Wakeman,

Marc Breton,

Emily Flint,

Kenny Kim,

Lindsay Roethke,

Mei Mei Church,

Camille André,

Molly Piper,

David Lam,

Grenye O’Malley,

Camilla Levister,

Selassie Ogyaadu,

Jessica Lovett,

Vinaya Simha,

Vikash Dadlani,

Shelly McCrady-Spitzer,

Corey Reid,

Kanchan Kumari,

G. Todd Alonso,

Robert H. Slover,

Emily Jost,

Laurel H. Messer,

Cari Berget,

Lindsey Towers,

Alex Rossick-Solis,

Tali Jacobson,

Marissa Town,

Ideen Tabatabai,

Jordan Keller,

Evalina Salas,

Francis J. Doyle,

Eyal Dassau,

Samantha Passman,

Tiffany Campos,

Carlos Murphy,

Nandan Patibandla,

Sarah Borgman,

Guillermo Arreaza-Rubín,

Neal Green,

Lori Laffel,

Jordan Pinsker,

Francis Doyle,

Eric Renard,

Claudio Cobelli,

Yves Reznik,

Robert Janicek,

Deanna Gabrielson,

Steven H. Belle,

Jessica R. Castle,

Jennifer Green,

Laurent Legault,

Steven M. Willi,

Carol Wysham,

Thomas Eggerman

Publication year - 2020

Publication title -

diabetes technology and therapeutics

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 2.142

H-Index - 88

eISSN - 1557-8593

pISSN - 1520-9156

DOI - 10.1089/dia.2020.0572

Subject(s) - medicine , glycemic , diabetes mellitus , closed loop , insulin , randomized controlled trial , loop (graph theory) , endocrinology , mathematics , combinatorics , control engineering , engineering

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).

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