Division of Endocrinology and Diabetes, Department of Pediatric Medicine, Sidra Medicine, HB 6E 219, Al Luqta Street, Education City North Campus, PO Box 26999, Doha, Qatar.
Acta Diabetol. 2021 Feb;58(2):207-213. doi: 10.1007/s00592-020-01607-4. Epub 2020 Oct 12.
To evaluate the effect of a 1-year hybrid closed-loop (HCL) system on glycemic control in children and adolescents with type 1 diabetes (T1D) previously treated with multiple daily injections (MDI).
This was a 1-year observational study, as a continuation of the previous 3 months prospective study of pediatric patients with T1D conducted at Sidra Medicine in Qatar. The study enrolled individuals aged 7-18 years with T1D > 1 year, on MDI with self-monitoring of blood glucose or continuous glucose monitoring, with no prior pump experience, and with an HbA1c level < 12.5% (< 113 mmol/mol). After the first 3 months of HCL use, patients were followed at 6, 9 and 12 months, where HbA1c was obtained and pump data were collected.
All 30 participants (age 10.24 ± 2.6 years) who initiated HCL completed 12 months of HCL system use in Auto Mode. The participants used the sensor 88.4 ± 6.5% of the time with Auto Mode usage 85.6 ± 7.4% during 12 months of HCL system use. HbA1c decreased from 8.2 ± 1.4% (66 ± 15.3 mmol/mol) at baseline, to 6.7 ± 0.5% (50 ± 5.5 mmol/mol) at 3 months (p = 0.02) and remained stable to 7.1 ± 0.6 (54 ± 6.6 mmol/mol) at 12 months (p = 0.02). TIR (70-180 mg/dL) increased from 46.9% at baseline to 71.9% at 1 month and remained above 70% during the 12 months of HCL use.
HCL system (MiniMed 670G) in children and adolescents previously treated with MDI significantly improves glycemic outcomes (HbA1c and Time in Ranges) immediately during the first month. This improved glycemic control was maintained over the 1 year following Auto Mode initiation.
评估在接受多次每日注射（MDI）治疗的 1 型糖尿病（T1D）儿童和青少年中使用为期 1 年的混合闭环（HCL）系统对血糖控制的影响。
这是一项为期 1 年的观察性研究，是在卡塔尔锡德拉医学中心进行的为期 3 个月的儿科 T1D 患者前瞻性研究的延续。该研究纳入了年龄在 7-18 岁、T1D 持续时间超过 1 年、接受 MDI 治疗并自我监测血糖或连续血糖监测、无先前胰岛素泵使用经验、HbA1c 水平<12.5%（<113mmol/mol）的患者。在使用 HCL 的最初 3 个月后，患者在 6、9 和 12 个月时进行随访，检测 HbA1c 并收集泵数据。
所有 30 名（年龄 10.24±2.6 岁）开始使用 HCL 的参与者均完成了 12 个月的 Auto 模式 HCL 系统使用。参与者在 Auto 模式下的传感器使用率为 88.4±6.5%，在 12 个月的 HCL 系统使用期间，Auto 模式使用率为 85.6±7.4%。HbA1c 从基线时的 8.2±1.4%（66±15.3mmol/mol）降至 3 个月时的 6.7±0.5%（50±5.5mmol/mol）（p=0.02），并在 12 个月时保持稳定在 7.1±0.6%（54±6.6mmol/mol）（p=0.02）。TIR（70-180mg/dL）从基线时的 46.9%增加到 1 个月时的 71.9%，并在使用 HCL 的 12 个月期间一直保持在 70%以上。
在接受 MDI 治疗的儿童和青少年中，HCL 系统（MiniMed 670G）可立即显著改善血糖控制（HbA1c 和时间范围），在启动 Auto 模式后的 1 年内持续改善血糖控制。
