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Closed-Loop Insulin Therapy Improves Glycemic Control in Adolescents and Young Adults: Outcomes from the International Diabetes Closed-Loop Trial.
Isganaitis, Elvira; Raghinaru, Dan; Ambler-Osborn, Louise; Pinsker, Jordan E; Buckingham, Bruce A; Wadwa, R Paul; Ekhlaspour, Laya; Kudva, Yogish C; Levy, Carol J; Forlenza, Gregory P; Beck, Roy W; Kollman, Craig; Lum, John W; Brown, Sue A; Laffel, Lori M.
Afiliación
  • Isganaitis E; Research Division, Department of Pediatrics, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA.
  • Raghinaru D; Jaeb Center for Health Research, Tampa, Florida, USA.
  • Ambler-Osborn L; Research Division, Department of Pediatrics, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA.
  • Pinsker JE; Sansum Diabetes Research Institute, Santa Barbara, CA, USA.
  • Buckingham BA; Pediatric Endocrinology and Diabetes, Stanford Children's Health, Stanford, California, USA.
  • Wadwa RP; Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
  • Ekhlaspour L; Pediatric Endocrinology and Diabetes, Stanford Children's Health, Stanford, California, USA.
  • Kudva YC; Division of Endocrinology, Diabetes, Metabolism, Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Levy CJ; Department of Medicine, Endocrinology, Diabetes and Bone Diseases, Mount Sinai Diabetes Center, New York, New York, USA.
  • Forlenza GP; Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
  • Beck RW; Jaeb Center for Health Research, Tampa, Florida, USA.
  • Kollman C; Jaeb Center for Health Research, Tampa, Florida, USA.
  • Lum JW; Jaeb Center for Health Research, Tampa, Florida, USA.
  • Brown SA; Endocrinology and Metabolism Division, Department of Medicine, Center for Diabetes Technology, University of Virginia, Charlottesville, Virginia, USA.
  • Laffel LM; Research Division, Department of Pediatrics, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA.
Diabetes Technol Ther ; 23(5): 342-349, 2021 05.
Article en En | MEDLINE | ID: mdl-33216667
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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Glucemia / Diabetes Mellitus Tipo 1 Tipo de estudio: Clinical_trials Límite: Adolescent / Adult / Humans Idioma: En Revista: Diabetes Technol Ther Asunto de la revista: ENDOCRINOLOGIA / TERAPEUTICA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Glucemia / Diabetes Mellitus Tipo 1 Tipo de estudio: Clinical_trials Límite: Adolescent / Adult / Humans Idioma: En Revista: Diabetes Technol Ther Asunto de la revista: ENDOCRINOLOGIA / TERAPEUTICA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos