Real-World Performance of First- Versus Second-Generation Automated Insulin Delivery Systems on a Pediatric Population With Type 1 Diabetes: A One-Year Observational Study
Authors' conclusion
Both systems showed sustained and successful glycemic outcomes in the first year of use. However, AHCL users achieved tighter glycemic targets, without an increase of hypoglycemia risk. Improved usability of the device may also have contributed to optimal glycemic outcomes by ensuring better continuity of the automatic mode activation.
Study context
- Population
- Children and adolescents with T1D aged 7 to 18 years switching to automated insulin delivery (AID) therapy; 55.6% females
- Participants
- 54 children
- Exposure
- Second-generation AID vs first-generation AID
- Outcome
- Real-world performance of AID systems: CGM metrics, system settings, insulin requirements and anthropometric parameters
- Follow-up
- Start period, six months, 12 months
Methodological detailssingle-centre, one-year follow-up, Data retrospectively gathered at start period, six months and 12 months
- Single-centre
- One-year follow-up
- Data retrospectively gathered at start period, six months and 12 months
Main finding
As reported in the abstract
CGM metrics · Two weeks after starting automatic mode
- Advanced hybrid closed-loop (AHCL) vs hybrid closed-loop (HCL): P = 0.016
- AHCL vs HCL: P = 0.022
- AHCL vs HCL: P = 0.047
- AHCL vs HCL: P = 0.012
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Mean sensor glucose and GMI · 12 monthsAHCL vs HCL · mean sensor glucose; better with AHCL | P = 0.021 |
| Mean sensor glucose and GMI · 12 monthsAHCL vs HCL · GMI; better with AHCL | P = 0.027 |
| Time in automatic mode and shifts to manual mode · every time point | P < 0.001 |
- Time in automatic mode and shifts to manual mode: longer time in automatic mode and fewer shifts to manual mode with second-generation AID
Mean sensor glucose and GMI · 12 months
- Both HCL and AHCL users achieved the recommended clinical targets over the entire study period
Original publication
Real-World Performance of First- Versus Second-Generation Automated Insulin Delivery Systems on a Pediatric Population With Type 1 Diabetes: A One-Year Observational Study. J Diabetes Sci Technol. Published 11 July 2023. doi:10.
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