Madrid-Valero Juan J, Scott Eleanor M, Boughton Charlotte K, Allen Janet M, Ware Julia, Wilinska Malgorzata E, Hartnell Sara, Thankamony Ajay, Randell Tabitha, Ghatak Atrayee, Besser Rachel E J, Elleri Daniela, Trevelyan Nicola, Campbell Fiona M, Hovorka Roman, Gregory Alice M
Department of Human Anatomy and Psychobiology, University of Murcia, Murcia, Spain.
Biomedical Research Institute of Murcia, IMIB-Arrixaca, Murcia, Spain.
J Diabetes Sci Technol. 2024 Oct 14:19322968241286816. doi: 10.1177/19322968241286816.
A diagnosis of type 1 diabetes in a young person can create vulnerability for sleep. Historically it has been rare for young people to be offered a closed-loop system soon after diagnosis meaning that studies examining sleep under these circumstances in comparison with standard treatment have not been possible. In this study, we examine sleep in young people (and their parents) who were provided with hybrid closed-loop therapy at diagnosis of type 1 diabetes versus those who receive standard treatment over a 2-year period.
The sample comprised 97 participants (mean age = 12.0 years; SD = 1.7) from a multicenter, open-label, randomized, parallel trial, where young people were randomized to either hybrid closed-loop insulin delivery or standard care at diagnosis. Sleep was measured using actigraphy and the Pittsburgh Sleep Quality Index (PSQI) in the young people, and using the PSQI in parents.
Sleep in young people using hybrid closed-loop insulin delivery did not differ significantly compared with those receiving standard care (although there were nonsignificant trends for better sleep in the closed-loop group for 4 of the 5 sleep actigraphy measures and PSQI). Similarly, there were nonsignificant differences for sleep between the groups at 24 months (with mixed direction of effects).
This study assessed for the first time sleep in young people using a closed-loop system soon after diagnosis. Although sleep was not significantly different for young people using closed-loop insulin delivery as compared with those receiving standard care, the direction of effects of the nonsignificant results indicates a possible tendency for better sleep quality in the hybrid closed-loop insulin delivery group at the beginning of the treatment.
年轻人被诊断为1型糖尿病后可能会出现睡眠问题。从历史上看，年轻人在确诊后很快就能使用闭环系统的情况很少见，这意味着无法进行研究来比较在这种情况下与标准治疗相比的睡眠情况。在本研究中，我们调查了在1型糖尿病确诊时接受混合闭环治疗的年轻人（及其父母）与接受标准治疗的年轻人在两年内的睡眠情况。
样本包括来自一项多中心、开放标签、随机、平行试验的97名参与者（平均年龄 = 12.0岁；标准差 = 1.7），其中年轻人在确诊时被随机分配接受混合闭环胰岛素输注或标准护理。使用活动记录仪和匹兹堡睡眠质量指数（PSQI）测量年轻人的睡眠情况，父母则使用PSQI进行测量。
与接受标准护理的年轻人相比，使用混合闭环胰岛素输注的年轻人的睡眠没有显著差异（尽管在5项睡眠活动记录仪测量和PSQI中的4项中，闭环组的睡眠有改善的非显著趋势）。同样，两组在24个月时的睡眠也没有显著差异（效果方向不一）。
本研究首次评估了确诊后不久使用闭环系统的年轻人的睡眠情况。虽然使用闭环胰岛素输注的年轻人与接受标准护理的年轻人的睡眠没有显著差异，但非显著结果的效果方向表明，在治疗开始时，混合闭环胰岛素输注组可能有睡眠质量更好的趋势。
