Closed‐loop control of type 1 diabetes in young children

Abstract

Journal of Paediatrics and Child HealthVolume 58, Issue 4 p. 734-734 Heads UpFree Access Closed-loop control of type 1 diabetes in young children First published: 26 February 2022 https://doi.org/10.1111/jpc.15929 edited by Craig Mellis (craig.mellis@sydney.edu.au) AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Management of type 1 diabetes in young children is difficult because of their unpredictable eating habits, variable insulin requirements and parents' fear of hypoglycaemia. Sensor-augmented pump therapy decreases hypoglycaemia and ketoacidosis in this age-group but has not been shown to improve glycaemic control. Hybrid closed-loop systems (i.e. artificial pancreas) in which an algorithm adjusts insulin delivery based on real-time sensor glucose levels have been used in adolescents. European researchers randomised 74 children aged 1–7 years, mean 5.6 (standard deviation = 1.6) years, to receive insulin via either a closed-loop system or sensor-augmented pump therapy (control) for 16 weeks; they then crossed over to the other treatment for 16 weeks in a multicentre, randomised, cross-over trial.1 The closed-loop period was significantly superior to standard pump therapy in terms of time with glucose levels in the target range (72 vs. 63%, P < 0.001, which equated to a clinically significant 125 min/day), time spent in a hyperglycaemic state, difference in glycated haemoglobin level and difference in mean sensor glucose level (Fig. 1). The time spent in a hypoglycaemic state was similar between treatments, but one child had a severe hypoglycaemic episode during the closed-loop period. A hybrid closed-loop system significantly improved glycaemic control in young children with type 1 diabetes. Fig. 1Open in figure viewerPowerPoint Sensor glucose levels. (), Closed-loop insulin delivery (), interquartile range (IQR)); (), sensor-augmented pump therapy (), IQR); (), target glucose range (N.B. 70 mg/dL = 3.9 mmol/L; 180 mg/dL = 10 mmol/L). Reference 1Ware J, Allen JM, Boughton CK et al. Randomized trial of closed-loop control in very young children with type 1 diabetes. N. Engl. J. Med. 2022; 386: 209– 19. CrossrefCASPubMedWeb of Science®Google Scholar Reviewers: David Isaacs, david.isaacs@health.nsw.gov.au, Children's Hospital at Westmead, Sydney; Lara Graves, lara.graves@health.nsw.gov.au, Children's Hospital at Westmead, Sydney Volume58, Issue4April 2022Pages 734-734 FiguresReferencesRelatedInformation