Evidence map›Paper›PMID 31548247›Full record

Observational studyDiabetes care2019

One Year Clinical Experience of the First Commercial Hybrid Closed-Loop System.

Rayhan A Lal, Marina Basina, David M Maahs, Korey Hood, Bruce Buckingham, Darrell M Wilson

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Diabetes care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 100 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
100citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

100 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Guideline
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  3. Pooled it
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  15. Article
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  17. Review
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  19. Article
  20. A Review of Real-World Evidence About the Use of Automated Insulin Delivery Systems in People With Type 1 Diabetes.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2025
    Review

40 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Rayhan A LalDivision of Endocrinology, Department of Medicine, Stanford University School of Medicine, Stanford, CA inforay@stanford.edu.ORCID 0000-0002-8055-944X
Marina BasinaDivision of Endocrinology, Department of Medicine, Stanford University School of Medicine, Stanford, CA.
David M MaahsDivision of Endocrinology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.
Korey HoodDivision of Endocrinology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.ORCID 0000-0001-5730-7749
Bruce BuckinghamDivision of Endocrinology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.
Darrell M WilsonDivision of Endocrinology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.

Funding

Stanford Center for Clinical & Translational Education and Research (Spectrum)UL1TR003142 · NCATS · STANFORD UNIVERSITY · PI O'HARA, RUTH M · 2019 to 2023
$45.0M
Spectrum Stanford Center for clinical and Translational Research and EducationUL1TR001085 · NCATS · STANFORD UNIVERSITY · PI CULLEN, MARK RICHARD, GREENBERG, HARRY BERNARD · 2013 to 2017
$37.1M
Stanford Islet Research CoreP30DK116074 · NIDDK · STANFORD UNIVERSITY · PI Seung K Kim · 2017 to 2026
$19.5M
Diabetes, Endocrinology and Metabolism Training GrantT32DK007217 · NIDDK · STANFORD UNIVERSITY · PI Justin Pierce Annes, David Matthew Maahs · 1987 to 2026
$7.2M
Training Research Leaders in Type 1 DiabetesK12DK122550 · NIDDK · STANFORD UNIVERSITY · PI MAAHS, DAVID MATTHEW · 2019 to 2023
$2.1M
NCATS NIH HHS UL1 TR001085NCATS NIH HHS UL1 TR003142NIDDK NIH HHS K12 DK122550NIDDK NIH HHS P30 DK116074NIDDK NIH HHS T32 DK007217
6 · The paper itself

Abstract

objectiveIn September 2016, the U.S. Food and Drug Administration approved the Medtronic 670G "hybrid" closed-loop system. In Auto Mode, this system automatically controls basal insulin delivery based on continuous glucose monitoring data but requires users to enter carbohydrates and blood glucose for boluses. To track real-world experience with this first commercial closed-loop device, we prospectively followed pediatric and adult patients starting the 670G system. RESEARCH DESIGN AND

methodsThis was a 1-year prospective observational study of patients with type 1 diabetes starting the 670G system between May 2017 and May 2018 in clinic.

resultsOf the total of 84 patients who received 670G and consented, 5 never returned for follow-up, with 79 (aged 9-61 years) providing data at 1 week and 3, 6, 9, and/or 12 months after Auto Mode initiation. For the 86% (68 out of 79) with 1-week data, 99% (67 out of 68) successfully started. By 3 months, at least 28% (22 out of 79) had stopped using Auto Mode; at 6 months, 34% (27 out of 79); at 9 months, 35% (28 out of 79); and by 12 months, 33% (26 out of 79). The primary reason for continuing Auto Mode was desire for increased time in range. Reasons for discontinuation included sensor issues in 62% (16 out of 26), problems obtaining supplies in 12% (3 out of 26), hypoglycemia fear in 12% (3 out of 26), multiple daily injection preference in 8% (2 out of 26), and sports in 8% (2 out of 26). At all visits, there was a significant correlation between hemoglobin A

conclusionsWhile Auto Mode utilization correlates with improved glycemic control, a focus on usability and human factors is necessary to ensure use of Auto Mode. Alarms and sensor calibration are a major patient concern, which future technology should alleviate.

Indexed as

Insulin Infusion SystemsAdolescentAdultBlood GlucoseBlood Glucose Self-MonitoringChildDiabetes Mellitus, Type 1Equipment DesignFemaleGlycated HemoglobinHumansHypoglycemiaHypoglycemic AgentsInsulinMaleMiddle AgedBlood GlucoseGlycated HemoglobinHypoglycemic AgentsInsulin

Identifiers

PMID31548247
PMCPMC6868462

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.