Endocrine Abstracts

Introduction: Hybrid closed-loop (HCL) systems are characterised by integrating continuous glucose monitoring (CGM) with insulin pumps which automate insulin delivery via specific algorithms and user-initiated insulin delivery.

Objectives: The aim of the study was to evaluate effectiveness of HCLs on HbA1c, time-in-range (TIR), hypoglycaemia frequency and quality of life measures in children and young people (CYP) with T1D, and their carers.

Methods: CYP with T1D on HCL were included in the study. Data on HbA1c, TIR and hypoglycaemia frequency was reviewed 3 months prior to starting the HCL and 3 months after. As part of clinical care, all patients and carers were provided with key education on the use of the HCL system by trained diabetes healthcare professionals. All patients and carers also completed the specific mandatory training for the relevant HCL system offered by the industry. CYP aged 12 years and above independently completed the validated Hypoglycaemia Fear Survey (HFS). Parents of patients <12 were asked to complete a modified version of the HFS-Parent survey. A structured questionnaire to assess the quality of life (QOL) impact was also used.

Results: There were 39 CYP (22 males) with T1D included with a mean age of 11.8 ± 4.4 SD (range 2.6-18.0) at commencement of HCL. Mean duration of diabetes was 3.8 years ± 2.8 SD. There were 55% of patients who were prepubertal. 91% were on the Tandem Control-IQ system and 9% on the CamAPS FX system. HCL use demonstrated significant improvements at 3 months prior compared to 3 months after commencement in the following: HbA1c (63.0 vs 56.6, P = 0.03), TIR (50.5 vs 67.0, P = 0.001) and frequency of hypoglycaemia (4.3% vs 2.8%, P = 0.004). HFS scores showed improved behaviour (34.0 vs 27.5.9, P = 0.02), worry (40.2 vs 31.6, P = 0.03) and HFS-P scores also showed improved behaviour (P < 0.001) and worry (P = 0.01). 76% of carers strongly agreed or agreed they slept better, 97% felt that the diabetes management had improved and 95% felt they had a better quality of life with the HCL.

Conclusion: Our study shows that HCL at 3 months improves glucose control, diabetes management and quality of life measures for patients and carers.