Evidence map›Paper›PMID 41571286›Full record

ArticleJournal of diabetes science and technology2026

Insulin Bolus Patterns in Newly Diagnosed Youth With Type 1 Diabetes Using a Hybrid Closed-Loop Insulin Delivery System.

Chloë Royston, Julia Ware, Janet M Allen, Malgorzata E Wilinska, Sara Hartnell, Ajay Thankamony, Tabitha Randell, Atrayee Ghatak, Rachel E J Besser, Daniela Elleri and 5 more

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Article in Journal of diabetes science and technology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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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

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Chloë RoystonInstitute of Metabolic Science-Metabolic Research Laboratories and Medical Research Council Metabolic Diseases Unit, University of Cambridge, Cambridge, UK.ORCID 0009-0006-4921-8467
Julia WareInstitute of Metabolic Science-Metabolic Research Laboratories and Medical Research Council Metabolic Diseases Unit, University of Cambridge, Cambridge, UK.ORCID 0000-0002-4497-0979
Janet M AllenInstitute of Metabolic Science-Metabolic Research Laboratories and Medical Research Council Metabolic Diseases Unit, University of Cambridge, Cambridge, UK.
Malgorzata E WilinskaInstitute of Metabolic Science-Metabolic Research Laboratories and Medical Research Council Metabolic Diseases Unit, University of Cambridge, Cambridge, UK.
Sara HartnellWolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, UK.
Ajay ThankamonyDepartment of Paediatrics, University of Cambridge, Cambridge, UK.
Tabitha RandellDepartment of Paediatric Diabetes and Endocrinology, Nottingham Children's Hospital, Nottingham, UK.
Atrayee GhatakDepartment of Diabetes, Alder Hey Children's National Health Service Foundation Trust, Liverpool, UK.
Rachel E J BesserDepartment of Paediatrics, University of Oxford, Oxford, UK.ORCID 0000-0002-4645-6324
Daniela ElleriDepartment of Diabetes, Royal Hospital for Sick Children, Edinburgh, UK.
Nicola TrevelyanPaediatric Diabetes, Southampton Children's Hospital, Southampton, UK.
Fiona M CampbellDepartment of Paediatric Diabetes, Leeds Children's Hospital, Leeds, UK.
Roman HovorkaInstitute of Metabolic Science-Metabolic Research Laboratories and Medical Research Council Metabolic Diseases Unit, University of Cambridge, Cambridge, UK.ORCID 0000-0003-2901-461X
Charlotte K BoughtonInstitute of Metabolic Science-Metabolic Research Laboratories and Medical Research Council Metabolic Diseases Unit, University of Cambridge, Cambridge, UK.ORCID 0000-0003-3272-9544
CLOuD Consortium

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aimed to investigate the decline over time in the proportion of total daily insulin delivered as boluses in newly diagnosed youth with type 1 diabetes using a hybrid closed-loop system.

methodA secondary analysis was conducted using data from the CLOuD study, an open-label, multicenter, randomized, parallel hybrid closed-loop trial to investigate bolus patterns in youth with newly diagnosed type 1 diabetes.

resultsOver the 48-month trial period, the proportion of total daily insulin delivered as carbohydrate-related boluses decreased from 58% to 34%. There was a decreasing trend in the median (interquartile range) amount of carbohydrates entered per day from 236 (204, 253) g to 184 (127, 232) g, and the number of carbohydrate-related boluses per day from 5.5 (4.6, 6.5) to 3.7 (2.9, 5.2) over the 48 months. Mean ± SD daily carbohydrate-related bolus insulin increased from 15.1 ± 6.6 to 22.0 ± 9.0 units/d, and the amount of insulin delivered per 10 g of carbohydrate more than doubled from 0.6 (0.5, 0.8) units to 1.3 (0.9, 1.5) units. The postprandial change in glucose (measured as the difference between peak glucose 30 to 180 minutes post carbohydrate-related bolus and glucose on carbohydrate-related bolus delivery) changed from 49 (45, 54) to 59 (53, 66) mg/dL.

conclusionsThe decline in the proportion of total daily insulin delivered for as bolus is likely attributable to a combination of missed boluses and under-bolusing, while the closed-loop algorithm compensates for the missed or insufficient carbohydrate-related insulin delivery by increasing basal insulin delivery.

Indexed as

bolus patternshybrid closed-loopnewly diagnosedtype 1 diabetes

Identifiers

PMID41571286
PMCPMC12827036

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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.