Barbara Davis Center for Diabetes, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.
Jaeb Center for Health Research, Tampa, Florida, USA.
Diabetes Technol Ther. 2021 Jun;23(6):401-409. doi: 10.1089/dia.2020.0532. Epub 2021 Jan 28.
Hybrid closed-loop systems increase time-in-range (TIR) and reduce glycemic variability. Person-reported outcomes (PROs) are essential to assess the utility of new devices and their impact on quality of life. This article focuses on the PROs for pediatric participants (ages 6-13 years) with type 1 diabetes (T1D) and their parents during a trial using the Tandem Control-IQ system, which was shown to increase TIR and improve other glycemic metrics. One hundred and one children 6 to 13 years old with T1D were randomly assigned to closed-loop control (CLC) or sensor-augmented pump (SAP) in a 16-week randomized clinical trial with extension to 28 weeks during which the SAP group crossed over to CLC. Health-related quality of life and treatment satisfaction measures were obtained from children and their parents at baseline, 16 weeks, and 28 weeks. Neither the children in the CLC group nor their parents had statistically significant changes in PRO outcomes compared with the SAP group at the end of the 16-week randomized controlled trial and the 28-week extension. Parents in the CLC group reported nonsignificant improvements in some PRO scores when compared with the SAP group at 16 weeks, which were sustained at 28 weeks. Sleep scores for parents improved from "poor sleep quality" to "adequate sleep quality" between baseline and 16 weeks, however, the change in scores was not statistically different between groups. Children with T1D who used the Control-IQ system did not experience increased burden compared with those using SAP based on person-reported outcomes from the children and their parents. Clinical Trials Registration: NCT03844789.
混合闭环系统可增加时间达标率(TIR)并降低血糖变异性。患者报告的结局(PROs)对于评估新设备的实用性及其对生活质量的影响至关重要。本文重点介绍了在使用 Tandem Control-IQ 系统的试验中,患有 1 型糖尿病(T1D)的儿科参与者(6-13 岁)及其父母的 PRO 结果,该系统可增加 TIR 并改善其他血糖指标。101 名 6-13 岁的 T1D 儿童被随机分配至闭环控制(CLC)或传感器增强型泵(SAP)组,在为期 16 周的随机临床试验中进行了扩展,在扩展的 28 周期间,SAP 组交叉至 CLC 组。在基线、16 周和 28 周时,从儿童及其父母处获得了与健康相关的生活质量和治疗满意度措施。与 SAP 组相比,在 16 周的随机对照试验结束时和 28 周的扩展期,CLC 组的儿童及其父母的 PRO 结果均无统计学意义的变化。与 SAP 组相比,CLC 组的父母在 16 周时报告一些 PRO 评分有显著改善,在 28 周时仍保持改善。与基线相比,父母的睡眠评分从“睡眠质量差”改善为“睡眠质量尚可”,但组间评分的变化无统计学意义。与使用 SAP 的儿童相比,使用 Control-IQ 系统的 T1D 儿童基于儿童及其父母的个人报告结果并未增加负担。临床试验注册:NCT03844789。