ESPE2024 Poster Category 2 Diabetes and Insulin (35 abstracts)
Hybrid closed loop systems: are they all the same? 1-year of follow-up outcomes of two hcls in children with type 1 diabetes: a real-life based study.
Laura Sayol-Torres , Ariadna Campos , Eduard Mogas , Nuria Gonzalez , Elena Garrido & Maria Clemente
Hospital Universitari Vall d'Hebron, Barcelona, Spain
Introduction: Many HCL-algorithms are available in pediatrics but real-life comparison studies are limited.
Objective: Analyze and compare metabolic control indicators achieved with the two HCLS used in our hospital in Children-with-T1D (CwD).
Methods: Retrospective descriptive study of CwD on HCLS treatment (Tandem with Control-IQ, Medtronic MiniMed780G). Data collection through clinical records review at baseline and every 3months. Determination of A1cHb (DCA-VantageSiemens). Analysis with SPSSv25 with statistical significance P <0.05. Outcomes: A1cHb and CGM-parameters including TIR (70-180 mg/dL); TAR1 (181-250 mg/dL); TAR2 (>250 mg/dL); TBR1 (54-69 mg/dL); TBR2 (<54 mg/dL); Mean Glucose and Coefficient of variation (CV).
Results: 61 patients (24male). The Control-IQ group was significantly younger at baseline. Control-IQ (A): 22patients (11male). Age 8.67±3.71. Previous treatment: 8 multiple-daily-injection (MDI), 14 Sensor-Augmented-Pump (SAP, Basal-IQ). MiniMed780G (B): 39patients (13male). Age 11.54±2.93. Previous treatment: 28 MDI, 5 SAP, 6 first-generation-HCL (Minimed670G).
| Start | 3months | 6months | 9months | 12months | p-value2 | |
| A1c A B p-value1 |
7.1±0.6 (22) 7.3±0.5 (39) 0.2 |
6.6±0.6* (19) 7.0±0.5* (30) 0.03 |
6.6±0.4* (15) 7.1±0.6* (31) 0.01 |
6.5±0.5* (16) 7.2±0.5 (25) 0.00 |
6.7±0.6 (15) 7.0±0.7* (23) 0.3 |
0.0016 |
| TIR A B p-value1 |
60.6±8.4 (22) 60.5±11.9 (39) 0.9 |
70.4±8.1* (22) 72.6±10.9* (39) 0.3 |
70.5±8.5* (20) 72.7±9.5* (38) 0.3 |
71.9±5.9* (18) 72.5±9.9* (33) 0.9 |
67.1±6.7* (16) 72.5±11.9* (30)0.02 |
0.055 |
| TAR1 A B p-value1 |
23.1±5.5(16) 26.3±8.2(35) 0.2 |
17.8±4.8* (21) 19.4±6.5* (39) 0.4 |
20.1±4.7* (20) 19.6±5.9* (38) 0.9 |
19.2±4.9* (18) 19.3±5.9* (33) 0.9 |
20.8±3.9 (16) 19.3±7.1* (30) 0.2 |
0.36 |
| TAR2 A B p-value1 |
10.8±6.5 (16) 10.7±6.7 (35) 0.9 |
7.5±5.6* (21) 6.0±6.2* (39) 0.3 |
8.6±5.3 (20) 5.9±5.2* (38) 0.1 |
5.9±2.6* (18) 6.7±5.3* (33) 0.6 |
9.9±5.4 (16) 6.4±6.5* (30)0.04 |
0.002 |
| CV A B p-value1 |
39.9±5.4 (21) 36.6±5.8 (37) 0.06 |
38.5±5.9 (22) 34.7±4.5* (39) 0.02 |
38.5±4.3 (20) 34.2±5.0* (38) 0.01 |
36.3±4.5* (18) 34.8±4.9* (33) 0.5 |
38.0±6.2 (15) 34.2±5.5* (30) 0.1 |
0.02 |
| A: Control-IQ / B: MiniMed780G Mean±SD (N) p-value1: difference between systems *Significant change from baseline (paired-data) p-value2: evolution trend difference (Interaction test repeated Anova for ranks) |
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Conclusion: HCLS improve metabolic control indicators without increasing hypoglycemia risk. Control-IQ shows an A1c improvement, while MiniMed780G has better results on CGM indicators (CV, TAR2).
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