Hybrid Closed Loop Overcomes the Impact of Missed or Suboptimal Meal Boluses on Glucose Control in Children with Type 1 Diabetes Compared to Sensor-Augmented Pump Therapy
Authors' conclusion
HCL persistently improves glycemic control compared with SAP, even in case of meal bolus omission.
Study context
- Population
- Children aged 6–12 years with T1D from the E/N arm of a multicentre RCT, free-living conditions6,817 days analysed
- Participants
- 60 children
- Comparison
- Hybrid closed-loop (HCL) vs sensor-augmented pump (SAP), according to missed meal boluses per day
- Primary endpoint
- TIR (70-180 mg/dL) according to the number of missed boluses per day
- Follow-up
- Last 28-30 days of each phase
Methodological detailsmulticenter
- Multicenter
Primary result
As reported in the abstract
EM mean TIR by missed meal boluses/day
SAP
54%
Estimated marginal (EM) mean · 95% CI 53–56
Each group vs SAPEstimate (95% CI)P value
24/7 HCL
difference (no bolus missed) 13%(11–15)
P < 0.05 for all comparisons vs. SAP24/7 HCL
difference (1 missed bolus/day) 15%(14–16)
P < 0.05 for all comparisons vs. SAP24/7 HCL
difference (≥2 missed boluses/day) 17%(6–28)
P < 0.05 for all comparisons vs. SAPFurther findings
| Outcome | SAP | E/N HCL | 24/7 HCL |
|---|---|---|---|
| Overall TIR | 54% ± 10% | 63% ± 7% | 67% ± 7% |
Days with ≥1 missed meal bolus · SAP phase to 72 weeks of HCL
- Percentage of days with at least one missed meal bolus increased from SAP to 72 weeks of HCL
- 12% to 22%
Original publication
Hybrid Closed Loop Overcomes the Impact of Missed or Suboptimal Meal Boluses on Glucose Control in Children with Type 1 Diabetes Compared to Sensor-Augmented Pump Therapy. Diabetes Technol Ther. Published 6 April 2023. doi:10.
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