PMID- 35488481
OWN - NLM
STAT- MEDLINE
DCOM- 20220617
LR  - 20221207
IS  - 1464-5491 (Electronic)
IS  - 0742-3071 (Linking)
VI  - 39
IP  - 7
DP  - 2022 Jul
TI  - Real-world prospective observational single-centre study: Hybrid closed loop 
      improves HbA1c, time-in-range and quality of life for children, young people and 
      their carers.
PG  - e14863
LID - 10.1111/dme.14863 [doi]
AB  - Hybrid closed-loop (HCL) systems are characterised by integrating continuous 
      glucose monitoring (CGM) with insulin pumps which automate insulin delivery via 
      specific algorithms and user-initiated insulin delivery. The aim of the study was 
      to evaluate the effectiveness of HCLs on Hba1c, time-in-range (TIR), time in 
      hypoglycaemia, fear of hypoglycaemia, sleep and quality of life measure in 
      children and young people (CYP) with T1D and their carers. Data on HbA1c, TIR and 
      hypoglycaemia frequency were reviewed at baseline prior to starting HCL and 
      3 months after commencement. As part of clinical care, all patients and carers 
      were provided with key education on the use of the HCL system by trained diabetes 
      healthcare professionals. CYP aged 12 years and above independently completed the 
      validated Hypoglycaemia Fear Survey (HFS). Parents of patients <12 were asked to 
      complete a modified version of the HFS-Parent (HFS-P) survey. There were 39 CYP 
      (22 men) with T1D included with a mean age of 11.8 +/- 4.4 at commencement of HCL. 
      Median duration of diabetes was 3.8 years (interquartile range 1.3-6.0). There 
      were 55% of patients who were prepubertal at the time of HCL commencement. 91% 
      were on the Control-IQ system and 9% on the CamAPS FX system. HCL use 
      demonstrated significant improvements at 3 months in the following: HbA1c in 
      mmol/mol (63.0 vs. 56.6, p = 0.03), TIR (50.5 vs. 67.0, p = 0.001) and time in 
      hypoglycaemia (4.3% vs. 2.8%, p = 0.004). HFS scores showed improved behaviour 
      (34.0 vs. 27.5.9, p = 0.02) and worry (40.2 vs. 31.6, p = 0.03), and HFS-P scores 
      also showed improved behaviour (p < 0.001) and worry (p = 0.01). Our study shows 
      that HCL at 3 months improves glucose control, diabetes management and quality of 
      life measures such as fear and worry of hypoglycaemia for CYP and carers.
CI  - (c) 2022 Diabetes UK.
FAU - Ng, Sze May
AU  - Ng SM
AUID- ORCID: 0000-0002-3449-0541
AD  - Department of Women's and Children's Health, University of Liverpool, Liverpool, 
      UK.
AD  - Paediatric Department, Southport and Ormskirk NHS Trust, Ormskirk, UK.
FAU - Katkat, Nancy
AU  - Katkat N
AD  - Paediatric Department, Southport and Ormskirk NHS Trust, Ormskirk, UK.
FAU - Day, Helen
AU  - Day H
AD  - Paediatric Department, Southport and Ormskirk NHS Trust, Ormskirk, UK.
FAU - Hubbard, Rebecca
AU  - Hubbard R
AD  - Paediatric Department, Southport and Ormskirk NHS Trust, Ormskirk, UK.
FAU - Quinn, Michelle
AU  - Quinn M
AD  - Paediatric Department, Southport and Ormskirk NHS Trust, Ormskirk, UK.
FAU - Finnigan, Lynne
AU  - Finnigan L
AD  - Paediatric Department, Southport and Ormskirk NHS Trust, Ormskirk, UK.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20220510
PL  - England
TA  - Diabet Med
JT  - Diabetic medicine : a journal of the British Diabetic Association
JID - 8500858
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Adolescent
MH  - Blood Glucose
MH  - Blood Glucose Self-Monitoring
MH  - Caregivers
MH  - Child
MH  - *Diabetes Mellitus, Type 1/drug therapy
MH  - Glycated Hemoglobin/analysis
MH  - Humans
MH  - *Hypoglycemia/chemically induced/prevention & control
MH  - Hypoglycemic Agents/therapeutic use
MH  - Insulin/therapeutic use
MH  - Insulin Infusion Systems
MH  - Male
MH  - Quality of Life
OTO - NOTNLM
OT  - children
OT  - glycaemic control
OT  - hybrid closed loop
OT  - quality of life
EDAT- 2022/05/01 06:00
MHDA- 2022/06/18 06:00
CRDT- 2022/04/30 03:12
PHST- 2022/04/24 00:00 [revised]
PHST- 2021/10/05 00:00 [received]
PHST- 2022/04/27 00:00 [accepted]
PHST- 2022/05/01 06:00 [pubmed]
PHST- 2022/06/18 06:00 [medline]
PHST- 2022/04/30 03:12 [entrez]
AID - 10.1111/dme.14863 [doi]
PST - ppublish
SO  - Diabet Med. 2022 Jul;39(7):e14863. doi: 10.1111/dme.14863. Epub 2022 May 10.