Abstract
Background and Aims
In the last 5 years usage of automatic insulin delivery systems is increasing among patients with T1D. It has been shown that they improve metabolic control, decrease time spent in hypoglycemia and episodes of nocturnal hypoglycemia, increase time spent in target and are feasible and safe.
Aim: To evaluate benefits in children/adolescents using do it yourself (DIY) unapproved loops vs sensor-augmented pump therapy (SAP).
Methods
A total of 43 families with child/children with T1D on pump treatment and continuous use of CGM were invited to participate in the study;31 (72.1%) families accepted.The children were followed for 196 patient months.
Results
The study group consists of 31 children with T1D;24 of all are on SAP;7 use DIY loops. No differences were observed in both groups for age, duration of diabetes and daily insulin dose(Tabl.1) Patients on DIY loops spent significantly more time in range(83 vs 68.8%,p=0.02),less time in hyperglycemia above 14 mmol/l (2.1vs 8.6%,p=0.02) and have better HbA1c at 6th month(6.5 vs 7.2%,p=0.006 ) vs SAP patients for the follow-up period.No severe hypoglycemia and DKA occurred.There are no gender differences between and within both groups.
Tabl.1
| SAP | DIY loops | ||
| Age,y | 9.1±2 | 10.1±2 | NS |
| Duration T1D,y | 4.9±2 | 5.0±1.7 | NS |
| Insulin dose(U/kg/d) | |||
| initial | 0.83±0.2 | 0.76±0.2 | NS |
| present | 0.75±0.2 | 0.79±0.2 | NS |
Conclusions
DIY unregistered loops systems show promising results for better metabolic control without increasing the risk of severe hypoglycemia and DKA at least in terms of mean BGLs. Further impact e.g. consumed fat/protein, insulin dose,macro- and microvascular complications,etc.,remain to be studied in larger and longer studies.
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