Closed-Loop Control system insulin administration effective for blood sugar control among kids with type 1 diabetes

A new study by Mosleh Jabari showed that in adolescents with type 1 diabetes, Closed-Loop Control (CLC) insulin administration had considerably higher day and night effectiveness and safety than Sensor-Augmented Insulin Pump (SAP) treatment. The findings of this study were published in Nature Scientific Reports.

Children suffering with diabetes mellitus (DM), which is a collection of metabolic illnesses rather than a single condition characterized by persistent hyperglycemia, have been a global concern. Glycemic objectives for children with T1DM have gotten increasingly stringent over time, and the average blood glucose (sugar) level goal for all children, regardless of age, is currently 70 to 120 mg/dL. Recent technological breakthroughs, such as insulin pumps and ongoing glucose monitoring devices, have transformed T1DM management.

A traditional therapy is the Sensor-Augmented Insulin Pump, which mimics pancreatic insulin production by continuous subcutaneous insulin infusion (CSII). The CLC insulin delivery systems are distinguished by real-time glucose-responsive administration of insulin and the combination of glucose-sensing and insulin-delivery components.

The goal of this meta-analysis is to evaluate the efficacy and safety of CLC to SAP in adolescents with type 1 diabetes (T1DM) by comparing glycemic results and hypoglycemia episodes.

Eleven randomized-controlled trials with a total of 570 patients were chosen from a total of 869 papers determined to follow PRISMA standards. The effectiveness of the therapy was determined by monitoring the mean Time In Range (TIR), blood glucose (BG), and Standard Deviation (SD) of the glucose fluctuation during the day, night, and during physical activities. The safety of the treatments was determined by monitoring hypoglycemia and hyperglycemic episodes during the day and night.

The key findings of this study were:

4.33, 16.61, and 8.27 are the pooled findings of a comparison of mean BG levels for day, night, and physical activities.

Monitoring for TIR 13.18, 15.36, and 7.39 during the day, night, and physical activity. SD of glucose variability was 0.40 and 0.86 throughout the day and night, respectively.

These figures demonstrate the advantages of the CLC system in terms of effectiveness.

The day, night, and physical activity observations of average blood glucose target hypoglycemia events 0.54, 0.04 and 0.00 and hyperglycemic events 0.04, 7.11 and 0.00 underscore CLC's remarkable safety factor.

Reference:

Jabari, M. (2023). Efficacy and safety of closed-loop control system for type one diabetes in adolescents a meta analysis. In Scientific Reports (Vol. 13, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1038/s41598-023-40423-y