Twelve‐month results of the ADAPT randomized controlled trial: Reproducibility and sustainability of advanced hybrid closed‐loop therapy outcomes versus conventional therapy in adults with type 1 diabetes
Authors' conclusion
ADAPT study phase glycaemic improvements were reproduced and sustained in the continuation phase, supporting the early adoption of AID therapy in people with type 1 diabetes not meeting glucose targets on MDI therapy.
Study context
- Population
- People with T1D on MDI+isCGM with HbA1c ≥8.0% (64 mmol/mol)entered continuation phase
- Participants
- 39 vs 36
- Comparison
- Automated insulin delivery (AID) vs MDI+isCGM; continuation: SWITCH to AID vs SUSTAIN AID
- SWITCHn = 39
- SUSTAINn = 36
- Primary endpoint
- Within-group change in mean HbA1c, with superiority in SWITCH and noninferiority in SUSTAIN
- Follow-up
- Between 6 and 12 months
Methodological detailsprospective, multicentre, open-label, 12-month continuation phase
- Prospective
- Multicentre
- Open-label
- 12-month continuation phase
Primary result
As reported in the abstract
Change in mean HbA1c · 6 to 12 months
| Group | Value | HbA1c at 6 months | HbA1c at 12 months (mmol/mol) | Within-group change |
|---|---|---|---|---|
| SWITCH | mean 7.5% (SD 0.6%) | 8.9% ± 0.8% (73.9 ± 8.6 mmol/mol) | 58.5 ± 6.9 | −1.4% (95% CI −1.7% to −1.1%; P < 0.001) |
| SUSTAIN | mean 7.4% (SD 0.8%) | 7.3% ± 0.6% (56.5 ± 6.7 mmol/mol) | 57.7 ± 9.1 | 0.1% (95% CI −0.05% to +0.25%) |
Value
SWITCHmean 7.5% (SD 0.6%)
SUSTAINmean 7.4% (SD 0.8%)
HbA1c at 6 months
SWITCH8.9% ± 0.8% (73.9 ± 8.6 mmol/mol)
SUSTAIN7.3% ± 0.6% (56.5 ± 6.7 mmol/mol)
HbA1c at 12 months (mmol/mol)
SWITCH58.5 ± 6.9
SUSTAIN57.7 ± 9.1
Within-group change
SWITCH−1.4% (95% CI −1.7% to −1.1%; P < 0.001)
SUSTAIN0.1% (95% CI −0.05% to +0.25%)
Safety
Severe hypoglycaemia during continuation phase · 6 to 12 months
- Severe hypoglycaemia events in two SWITCH participants
- 3 events
Original publication
Twelve‐month results of the ADAPT randomized controlled trial: Reproducibility and sustainability of advanced hybrid closed‐loop therapy outcomes versus conventional therapy in adults with type 1 diabetes. Diabetes Obes Metab. Published 8 August 2023. doi:10.
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