BSPED2023 Oral Communications Oral Communications 9 (9 abstracts)
Impact of using hybrid closed loop system in a tertiary children’s hospital: a single centre experience
Eman B. Kamaleldeen 1,2 , Tabitha L Randell 1 & Pooja Sachdev 1
1Department of Paediatric Endocrinology, Nottingham Children’s Hospital, Nottingham, United Kingdom. 2Pediatrics Endocrinology Unit, Department of Paediatrics, Faculty of Medicine, Assiut Universit, Assuit, Egypt
Background: Hybrid closed loop (HCL) insulin systems are associated with better glycaemic control and reduced hypoglycaemia risk. They represent the most advanced form of insulin delivery for people with type 1 diabetes mellitus (T1DM).
Aim: The study aimed to evaluate effectiveness of 3 HCL systems in children and young people (CYP) with T1DM at Nottingham Children’s Hospital.
Methods: Data on HBA1c, TIR, hypo and hyperglycaemia three months before starting HCL and at 3, 6 and 12 months after HCL commencement were collected from Diasend® system (Glooko), Dexcom Clarity, and Care link (October 2019 - September 2022). Time in Hypoglycaemia (TIHo) and hyperglycaemia (TIHi) percentage were calculated as combination of percentage of low and very low and high and very high respectively.
Results: Patients on HCL n=128; 12-month data available for 98 patients. Mean age 10.5 (4.3) years, 65 boys (50%), diabetes duration 4.2 (3.8) years, 75% White British. Fourteen patients Medtronic MiniMedTM 780G, 30 CamAPS FX (CamDiab, Cambridge, UK), 82 Tandem Control-IQ AP system, 2 DIY Closed Loop (excluded).
| 3-month prior starting | 3-month after starting HCL | 6 months after HCL | 12 months after HCL | |
| Mean HbA1c (mmol/mol) (SD) | 57 (9.7) | 52 (7.3) | 51.4 (7.1) | 51.4 (7.1) |
| Mean TIR% | 56.4 | 66.3 | 65.3 | 67.2 |
| TIHo % | 3.6 | 2.8 | 2.9 | 3.1 |
| TIHi % | 39.6 | 30.09 | 30.8 | 29.2 |
| Average HbA1c | Period after HCL (months) | 780 G | Cam APS | Control IQ |
| 3 | 54.6 | 51 | 51.9 | |
| 6 | 51.2 | 50.4 | 51.7 | |
| 12 | 59.3 | 50.5 | 50.5 | |
| TIR | 3 | 73.9 | 63.2 | 66.1 |
| 6 | 75.9 | 64.6 | 64.2 | |
| 12 | 73 | 69.3 | 66.6 | |
| % hypos | 3 | 4 | 3.6 | 2.4 |
| 6 | 4.2 | 3.7 | 2.5 | |
| 12 | 2.7 | 4.5 | 2.8 | |
| % hyperglycaemia | 3 | 21.4 | 31.6 | 31 |
| 6 | 18.8 | 30.1 | 32.9 | |
| 12 | 24.8 | 29.5 | 29.8 |
Conclusions: Improvements in HBA1c, TIR, and time in hyperglycaemia were seen with HCL for 3 months & was sustained at 12 months in all 3 systems. Comparison within the 3 systems was not possible due to different numbers using each system and confounding factors such as eligibility for a particular system.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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