Hybrid closed-loop system viable for children with type 1 diabetes
SAN DIEGO — A hybrid-closed loop insulin control system used in children with type 1 diabetes was safe for both overall and overnight control and resulted in no severe hypoglycemic episodes, according to a speaker here.
“There’s a lot of work being done now on hybrid closed-loop systems. Hybrid means that it will modulate the basal amount of insulin throughout the day as well as night,” Bruce A. Buckingham, MD, a professor in the department of pediatrics, division of endocrinology and diabetes, Stanford University, said during his presentation. “We have done previous studies with this OmniPod system, testing it in adults and adolescents, so we wanted to move into the pediatric range where kids are often more sensitive to insulin and they have more variability in their glucose levels.”
Buckingham and colleagues evaluated 12 children (mean age, 9.5 years) with type 1 diabetes (mean diabetes duration, 4.6 years; mean HbA1c, 7.8%; mean total daily insulin dose, 0.9 U/kg) to investigate the performance of an automated glucose control algorithm using the Omnipod Insulin Management System (Insulet Corp.). Participants were given three meals per day consisting of 30 g to 90 g carbohydrates and had limited physical activity.
Mean glucose was 157 mg/dL overall and 149 mg/dL overnight. Percent time in range (70-180 mg/dL) was 70.1% overall and 86.7% overnight. There was 2% hypoglycemia (< 70 mg/dL) overall and 0.1% overnight showing that the system was safe overnight.
“The system was safe during the day and night. We didn’t see any severe hypoglycemia,” Buckingham said. “In further studies, we will modify the algorithm, and we want to test in free-living conditions over an extended period of time. This hybrid closed-loop control is a new paradigm that’s really changing the way we’re caring for families [with diabetes], and families can now expect safe sleep without having to worry about severe lows and severe highs.” – by Amber Cox
Buckingham BA, et al. 132-LB. Presented at: American Diabetes Association 77th Scientific Sessions; June 9-13, 2017; San Diego.
Disclosure : Buckingham reports receiving research funding from Bigfoot Biomedical, Dexcom, Insulet Corp., Medtronic and Tandem Diabetes, and is an advisory board member for Novo Nordisk and Sanofi.