Evidence map›Paper›PMID 31837064›Full record

Observational studyPediatric diabetes2020

Six months of hybrid closed loop in the real-world: An evaluation of children and young adults using the 670G system.

Cari Berget, Laurel H Messer, Tim Vigers, Brigitte I Frohnert, Laura Pyle, R Paul Wadwa, Kimberly A Driscoll, Gregory P Forlenza

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

Observational study in Pediatric diabetes, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
65citing papers in PubMed, 2 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

65 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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5 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

8 authors.

Cari BergetUniversity of Colorado Anschutz Campus, School of Medicine, Barbara Davis Center for Childhood Diabetes, Aurora, Colorado.
Laurel H MesserUniversity of Colorado Anschutz Campus, School of Medicine, Barbara Davis Center for Childhood Diabetes, Aurora, Colorado.
Tim VigersDepartment of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado.ORCID 0000-0001-7087-8570
Brigitte I FrohnertUniversity of Colorado Anschutz Campus, School of Medicine, Barbara Davis Center for Childhood Diabetes, Aurora, Colorado.
Laura PyleUniversity of Colorado Anschutz Campus, School of Medicine, Barbara Davis Center for Childhood Diabetes, Aurora, Colorado.
R Paul WadwaUniversity of Colorado Anschutz Campus, School of Medicine, Barbara Davis Center for Childhood Diabetes, Aurora, Colorado.
Kimberly A DriscollUniversity of Colorado Anschutz Campus, School of Medicine, Barbara Davis Center for Childhood Diabetes, Aurora, Colorado.
Gregory P ForlenzaUniversity of Colorado Anschutz Campus, School of Medicine, Barbara Davis Center for Childhood Diabetes, Aurora, Colorado.ORCID 0000-0003-3607-9788

Funding

K12 Career DevelopmentK12DK094712 · NIDDK · UNIVERSITY OF COLORADO DENVER · PI STECK, ANDREA · 2011 to 2021
$4.5M
Juvenile Diabetes Research Foundation 5-ECR-2019-736-A-NNIDDK NIH HHS K12 DK094712NIDDK NIH HHS K12DK094712
6 · The paper itself

Abstract

objectiveTo describe glycemic and psychosocial outcomes in youth with type 1 diabetes using a hybrid closed loop (HCL) system. SUBJECTS: Youth with type 1 diabetes (2-25 years) starting the 670G HCL system for their diabetes care were enrolled in an observational study.

methodsProspective data collection occurred during routine clinical care and included glycemic variables (sensor time in range [70-180 mg/dL], HbA1c), and psychosocial variables (Hypoglycemia Fear Survey [HFS]; Problem Areas in Diabetes [PAID]). Mixed models were used to analyze change across time.

resultsNinety-two youth (mean age 15.7 ± 3.6 years, 50% female, HbA1c 8.8% ± 1.8%) started HCL for their diabetes care. Youth used Auto Mode 65.5% ± 3.0% of the time at month 1, which decreased to 51.2% ± 3.4% at month 6 (P = .001). Sensor time in range increased from 50.7% ± 1.8% at baseline to 56.9% ± 2.1% at 6 months (P = .007). HbA1c decreased from 8.7% ± 0.2% at baseline to 8.4% ± 0.2% after 6 months of use (P ≤ .0001), with the greatest HbA1c decline in participants with high baseline HbA1c. Increased percent time in auto mode was associated with lower HbA1c (P = .02). Thirty percent of youth discontinued HCL in the first 6 months of use. There were no changes in the HFS or PAID scores across time.

conclusionsHCL use is associated with improved glycemic control and no change in psychosocial outcomes in this clinical sample. The decline in HCL use across time suggests that youth experience barriers in sustaining use of HCL. Further research is needed to understand reasons for HCL discontinuation and determine intervention strategies.

Indexed as

AdolescentDiabetes Mellitus, Type 1FemaleGlycated HemoglobinGlycemic ControlHumansHypoglycemiaHypoglycemic AgentsInsulinInsulin Infusion SystemsMaleYoung AdultGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsInsulinartificial pancreasautomated insulin deliverycontinuous glucose monitorpediatrics

Identifiers

PMID31837064
PMCPMC7204168

What OpenQuestion holds

Textmetadata
LicenceTDM
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.