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Comparison of two advanced hybrid closed loop in a pediatric population with type 1 diabetes: a real-life observational study

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Abstract

Objective

The Advanced Hybrid Closed Loop (AHCL) systems have provided the potential to ameliorate glucose control in children with Type 1 Diabetes. The aim of the present work was to compare metabolic control obtained with 2 AHCL systems (Medtronic 780G system and Tandem Control IQ system) in a pediatric real-life clinical context.

Research design and methods

It is an observational, real-life, monocentric study; thirty one children and adolescents (M:F = 15:16, age range 7.6–18 years, mean age 13.05 ± 2.4 years, Diabetes duration > 1 year) with T1D, previously treated with Predictive Low Glucose Suspend (PLGS) systems and then upgraded to AHCL have been enrolled. CGM data of the last four weeks of “PLGS system” (PRE period) with the first four weeks of AHCL system (POST period) have been compared.

Results

For both AHCL systems, Medtronic 780G and Tandem Control IQ, respectively TIR at 4 weeks significantly increased, from 65.7 to 70.5% (p < 0.01) and from 64.8 to 70.1% (p < 0.01). (p < 0.01). The comparison between CGM metrics of the 2 evaluated systems doesn’t show difference at baseline (last four weeks of PLGS system) and after four weeks of AHCL use.

Conclusions

To our knowledge, this study is the first real-life one comparing 2 AHCL systems in a pediatric population with T1D. It shows an improvement in glucose control when upgrading to AHCL. The comparison between the two AHCL systems did not show significant differences in the analyzed CGM metrics, meaning that the algorithms currently available are equally effective in promoting glucose control.

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Funding

The guarantor's name is Riccardo Schiaffini. No funding/financial support and conflict of interest exist.

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Authors and Affiliations

  1. Diabetes Unit, Bambino Gesù Children’s Hospital, Piazza S Onofrio, 4, 00165, Rome, Italy

    R. Schiaffini, A. Deodati, C. Carducci, P. Ciampalini, A. Lorubbio, M. C. Matteoli, V. Pampanini, I. P. Patera, N. Rapini & S. Cianfarani

  2. Pediatric Department, Siena University, Siena, Italy

    M. C. Nicoletti

  3. Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden

    S. Cianfarani

  4. Department of Public Health and Cell Biology, Rina Balducci Center of Pediatric Endocrinology, Tor Vergata University, Rome, Italy

    S. Cianfarani

Authors
  1. R. Schiaffini
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  2. A. Deodati
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  3. M. C. Nicoletti
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  4. C. Carducci
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  5. P. Ciampalini
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  6. A. Lorubbio
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  7. M. C. Matteoli
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  8. V. Pampanini
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  9. I. P. Patera
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  10. N. Rapini
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  11. S. Cianfarani
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Contributions

The author contributions are as follows: RS, AD, and MCN engaged in literature retrieval of the articles, have analyzed the results and wrote the manuscript. NR contributed to wrote the manuscript and discussed on literature analysis. CC, PC, AL, MCM, VP, IPP and SC critically revised the manuscript. All authors approved the manuscript.

Corresponding author

Correspondence to R. Schiaffini.

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Conflict of interest

Potential conflict of interest do not exist.

Ethical Standard Statement

The study was conducted according to the Declaration of Helsinki. The study protocol was ethically approved by the Bambino Gesù Childrens’ Hospital Ethics Committee as part of the project for the systematic monitoring program of assistance in pediatric diabetology (February 4th, 2020—Prot 100).

Informed consent

Participants and their parents provided informed consent to have their CGM data downloaded at regular intervals, as part of routine clinical control.

Additional information

Managed by Massimo Porta.

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Novelty statement: the paper presents comparative data between 2 AHCL systems in an exclusively pediatric population and opens up prospects for the clinical application of these devices in a poorly studied age group, with which it is believed that glycometabolic control can be significantly improved.

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Schiaffini, R., Deodati, A., Nicoletti, M.C. et al. Comparison of two advanced hybrid closed loop in a pediatric population with type 1 diabetes: a real-life observational study. Acta Diabetol 59, 959–964 (2022). https://doi.org/10.1007/s00592-022-01886-z

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  • DOI: https://doi.org/10.1007/s00592-022-01886-z

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