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In-home hybrid closed-loop insulin system safe, effective in adolescents, adults
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Adolescents and adults with type 1 diabetes using a hybrid closed-loop insulin-delivery system safely and effectively increased time in target and reduced HbA1c, hyperglycemia and hypoglycemia at home, according to findings published in Diabetes Technology & Therapeutics.
Satish K. Garg, MD, of the Barbara Davis Center for Diabetes, University of Colorado Denver, and colleagues evaluated 30 adolescents (mean age, 16.5 years) and 94 adults (mean age, 44.6 years) with type 1 diabetes using the MiniMed 670G system (Medtronic) during a 2-week run-in phase without hybrid closed-loop control and then with closed-loop control during a 3-month study phase. Participants attended a supervised hotel stay for 6 days and 5 nights that included 24-hour frequent blood-sample testing with a reference measurement.
The system was used for a median 75.8% of the time among adolescents and a median 88% of the time among adults.
Overall, mean in-target sensor glucose values increased from 60.4% during the run-in phase to 67.2% during the study phase in adolescents (P < .001) and from 68.8% during the run-in phase to 73.8% during the study phase in adults (P < .001).
From baseline to end of study, HbA1c levels decreased from a mean 7.7% to 7.1% in adolescents (P < .001) and from 7.3% to 6.8% in adults (P < .001).
No severe hypoglycemic or diabetic ketoacidosis events were reported.
“Results of this pivotal trial support and extend those from earlier studies of [hybrid closed-loop] systems (from Medtronic and other investigators) that were conducted under closely supervised conditions, or for shorter durations, and enrolled fewer subjects,” the researchers wrote. “Data reported here suggest that the present system is effective for adolescents and adults and that it may benefit patients as they strive to improve overall glycemic control, while minimizing hypoglycemia. The ability of this integrated system to automatically and safely increase, decrease and suspend insulin delivery represents an important advance in type 1 diabetes therapy for individuals with diabetes, their families and their health care teams.” – by Amber Cox
Disclosure: Garg reports various financial ties with Medtronic. Please see the full study for a list of all other authors’ relevant financial disclosures.
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