Department of Paediatric Endocrinology and Diabetes, Charité - Universitätsmedizin Berlin, Berlin, Germany.
The Insight Centre for Data Analytics, University College Dublin, Belfield, Ireland.
JMIR Mhealth Uhealth. 2019 Jul 30;7(7):e14087. doi: 10.2196/14087.
Patient-driven initiatives have made uptake of Do-it-Yourself Artificial Pancreas Systems (DIYAPS) increasingly popular among people with diabetes of all ages. Observational studies have shown improvements in glycemic control and quality of life among adults with diabetes. However, there is a lack of research examining outcomes of children and adolescents with DIYAPS in everyday life and their social context.
This survey assesses the self-reported clinical outcomes of a pediatric population using DIYAPS in the real world.
An online survey was distributed to caregivers to assess the hemoglobin A levels and time in range (TIR) before and after DIYAPS initiation and problems during DIYAPS use.
A total of 209 caregivers of children from 21 countries responded to the survey. Of the children, 47.4% were female, with a median age of 10 years, and 99.4% had type 1 diabetes, with a median duration of 4.3 years (SD 3.9). The median duration of DIYAPS use was 7.5 (SD 10.0) months. Clinical outcomes improved significantly, including the hemoglobin A levels (from 6.91% [SD 0.88%] to 6.27% [SD 0.67]; P<.001) and TIR (from 64.2% [SD 15.94] to 80.68% [SD 9.26]; P<.001).
Improved glycemic outcomes were found across all pediatric age groups, including adolescents and very young children. These findings are in line with clinical trial results from commercially developed closed-loop systems.
患者驱动的举措使得 DIYAPS（自行设计的人工胰腺系统）在各个年龄段的糖尿病患者中的使用率越来越高。观察性研究表明，成年人的血糖控制和生活质量得到了改善。然而，目前缺乏研究来检查日常使用 DIYAPS 的儿童和青少年的结果及其社会背景。
本调查通过在现实生活中使用 DIYAPS 评估儿科人群的自我报告临床结果。
向护理人员分发在线调查，以评估 DIYAPS 启动前后的血红蛋白 A 水平和时间在目标范围内（TIR）以及 DIYAPS 使用过程中出现的问题。
共有来自 21 个国家的 209 名儿童护理人员对该调查做出了回应。这些儿童中，47.4%为女性，中位数年龄为 10 岁，99.4%患有 1 型糖尿病，中位数病程为 4.3 年（标准差 3.9）。使用 DIYAPS 的中位数时间为 7.5 个月（标准差 10.0）。临床结果显著改善，包括血红蛋白 A 水平（从 6.91%[标准差 0.88%]降至 6.27%[标准差 0.67%]；P<.001）和 TIR（从 64.2%[标准差 15.94%]升至 80.68%[标准差 9.26%]；P<.001）。
在所有儿科年龄组中，包括青少年和非常年幼的儿童，都发现了血糖控制的改善。这些发现与商业化闭环系统的临床试验结果一致。
