Effectiveness of a closed-loop control system and a virtual educational camp for children and adolescents with type 1 diabetes: A prospective, multicentre, real-life study

Valentino Cherubini,Ivana Rabbone,Maria Giulia Berioli,Sara Giorda,Donatella Lo Presti,Giulio Maltoni,Chiara Mameli,Marco Marigliano,Monica Marino,Nicola Minuto,Enza Mozzillo,Elvira Piccinno,Barbara Predieri,Carlo Ripoli,Riccardo Schiaffini,Andrea Rigamonti,Giuseppina Salzano,Davide Tinti,Sonia Toni,Angela Zanfardino,Andrea E. Scaramuzza,Rosaria Gesuita, Valentina Tiberi, Silvia Savastio, Ciro Pigniatiello, Michela Trada, Stefano Zucchini, Francesca Chiara Redaelli, Claudio Maffeis, Marta Bassi, Francesco Maria Rosanio, Maurizio Delvecchio, Patrizia Buzzi, Maria Rossella Ricciardi, Chiara Carducci, Riccardo Bonfanti, Fortunato Lombardo, Barbara Piccini, Dario Iafusco, Michela Calandretti, Federico Abate Daga

DIABETES OBESITY & METABOLISM(2021)

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摘要
Aim To evaluate the impact of a virtual educational camp (vEC) on glucose control in children and adolescents with type 1 diabetes using a closed-loop control (CLC) system. Materials and Methods This was a prospective multicentre study of children and adolescents with type 1 diabetes using the Tandem Basal-IQ system. Insulin pumps were upgraded to Control-IQ, and children and their parents participated in a 3-day multidisciplinary vEC. Clinical data, glucose metrics and HbA1c were evaluated over the 12 weeks prior to the Control-IQ update and over the 12 weeks after the vEC. Results Forty-three children and adolescents (aged 7-16 years) with type 1 diabetes and their families participated in the vEC. The median percentage of time in target range (70-180 mg/dL; TIR) increased from 64% (interquartile range [IQR] 56%-73%) with Basal-IQ to 76% (IQR 71%-81%) with Control-IQ (P < .001). After the vEC, more than 75% of participants achieved a TIR of more than 70%. The percentage of time between 180 and 250 mg/dL and above 250 mg/dL decreased by 5% (P < .01) and 6% (P < .01), respectively, while the time between 70 and 54 mg/dL and below 54 mg/dL remained low and unaltered. HbA1c decreased by 0.5% (P < .01). There were no episodes of diabetic ketoacidosis or severe hypoglycaemia. Conclusions In this study of children managing their diabetes in a real-world setting, more than 75% of children who participated in a vEC after starting a CLC system could obtain and maintain a TIR of more than 70%. The vEC was feasible and resulted in a significant and persistent improvement in TIR in children and adolescents with type 1 diabetes.
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关键词
continuous glucose monitoring,CSII,glycaemic control,insulin pump therapy,observational study,type 1 diabetes
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