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Evaluation of real‐life clinical outcomes in Australian youth with type 1 diabetes on hybrid closed‐loop therapy: A retrospective study
Author(s) -
Vijayanand Sathyakala,
Stevenson Paul G,
Broad Elizabeth,
Davis Elizabeth A,
Taplin Craig E,
Jones Timothy W,
Abraham Mary B
Publication year - 2022
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.16043
Subject(s) - medicine , type 1 diabetes , retrospective cohort study , diabetes mellitus , pediatrics , type 2 diabetes , endocrinology
Aim To determine the clinical outcomes and evaluate the perspectives of children with Type 1 diabetes (T1D) and their parents managing their child on hybrid closed‐loop (HCL) therapy. Methods Children with T1D on HCL attending a tertiary diabetes centre between April 2019 and July 2021 were included. A retrospective analysis of glycaemic data was conducted to determine the clinical outcomes. Time spent in closed loop, time in target glucose range (TIR 3.9–10 mmol/L), hypoglycaemia and hyperglycaemia were collected at baseline, 4 weeks, 3 and 6 months post‐HCL. User experience was assessed by questionnaires administered to parents of children with T1D. Results Seventy‐one children, mean (SD) age of 12.2 (3.2) years were commenced on HCL. Ten (14%) discontinued HCL use, with 60% discontinuing within the first 6 months. Glycaemic outcomes were analysed in 52 children. Time spent in closed loop was 78 (21) % at 4 weeks, declined to 69 (28) % at 3 months ( P = 0.037) and 63 (34) % at 6 months ( P = 0.001). The mean %TIR increased from 59.8 at baseline to 67.6 at 3 months and 65.6 at 6 months with a mean adjusted difference of 7.8% points [95% CI 3.6, 11.9] and 5.5% points [95% CI 1.4, 9.5], respectively. There was a reduction in time > 10 mmol/L and time < 3.9 mmol/L from baseline to 6 months. Although families faced challenges with technology, better glucose control with reduced glycaemic fluctuations were reported. Conclusions HCL therapy is associated with improved glycaemia; however, adequate support and education are required for best outcomes.