Compared with sensor-augmented pump therapy, a hybrid closedloop system improves glycemic control in young children with type 1 diabetes (T1D), according to a study published in the New England Journal of Medicine. Julia Ware, MD, and colleagues recruited 74 children aged 1-7 with T1D who were receiving insulin-pump therapy for a multicenter, randomized, crossover trial. Participants received treatment in two 16-week periods in random order, during which the closed-loop system compared with sensoraugmented pump therapy (control). The percentage of time with the glucose level in the target range (70-180 mg/dL) was 8.7 percentage points higher during the closed-loop versus the control period. The mean adjusted difference in the percentage of time spent in a hyperglycemic state was −8.5 percentage points for closed-loop minus control; the difference in the glycated hemoglobin level was −0.4 percentage points; and the difference in mean sensor glucose level was −12.3 mg/dL. The two treatments yielded a similar time spent in the hypoglycemic state. During the 16-week closed-loop period, the median time spent in the closed-loop mode was 95%. During the closed-loop period, there was one serious adverse event of severe hypoglycemia.
