Hybrid Closed-Loop Therapy Improves Diabetes Outcomes, Study Reveals

Automation in closed-loop systems improves type 1 diabetes outcomes and glucose profiles in teens, according to a study published in JAMA Pediatrics.

Six months of hybrid closed-loop therapy can significantly improve both glycemic control and quality of life in pediatric patients with type 1 diabetes (T1D), according to research results published in JAMA Pediatrics.1

Researchers studied patients with T1D to determine the effectiveness of hybrid closed-loop therapy compared with traditional therapies. The study was conducted over a 6-month period and included 172 children with T1D from Australia. The study took place from April 2017 to February 2021.

Patients were split into 2 groups. The control group were given conventional continuous subcutaneous insulin infusion or multiple daily insulin injections. The intervention group received hybrid closed-loop therapy.

The mean patient age was 15.3 years (56% girls). Sixty-eight patients were randomly assigned to the control group, and 67 to the hybrid closed-loop group. Mean diabetes duration was 7.7 years and mean HbA1c was 64 mmol/mol. Overall, 81% receiving continuous subcutaneous insulin infusion and 53% receiving continuous glucose monitoring therapies.

Time in range increased from a mean of 53.1% at baseline to 62.5% at the end of the study in the hybrid closed-loop group. It also increased from 54.6% to 56.1% in the control group, with a mean adjusted difference between the 2 groups of 6.7%.

Hybrid closed-loop therapy also reduced the time that patients spent in a hypoglycemic range (difference, −1.9%; 95% CI, −2.5% to −1.3%) and improved glycemic variability (−5.7%; 95% CI, −10.2% to −0.9%). Hybrid closed-loop therapy was associated with improved quality of life for patients with diabetes.

“This improvement in outcomes could be due to the reduced worry, increased confidence and trust in the system with improved glycemic control, and increased ownership of diabetes management that were experienced by HCL users,” researchers wrote.

“To our knowledge, this is the first [randomized controlled trial] in youth with T1D to provide conclusive evidence that [hybrid closed-loop improves glycemic outcomes and quality of life,” they concluded. “The [hybrid closed-loop] system represents an important step in the pursuit of technological advancements towards a fully automated closed loop system.”

Reference

  1. Abraham MB, de Bock M, Smith GJ, et al. Effect of a hybrid closed-loop system on glycemic and psychosocial outcomes in children and adolescents with type 1 diabetes: A randomized clinical trial. JAMA Pediatrics. 2021;175(12):1227-1235. doi:10.1001/jamapediatrics.2021.3965