A comparison of two hybrid closed-loop systems in adolescents and young adults with type 1 diabetes (FLAIR): a multicentre, randomised, crossover trial

Bergenstal, Richard M.; Nimri, Revital; Beck, Roy W.; Criego, Amy; Laffel, Lori M.; Schatz, Desmond; Battelino, Tadej; Danne, Thomas; Weinzimer, Stuart A.; Sibayan, Judy; Johnson, Mary Lynn; Bailey, Ryan; Calhoun, Peter; Carlson, Anders; Isganaitis, Elvira; Bello, Rachel; Albanese‐O’Neill, Anastasia; Dovč, Klemen; Biester, Torben; Weyman, Kate; Hood, Korey K.; Phillip, Moshe

doi:10.1016/s0140-6736(20)32514-9

Cited by 224 publications

(149 citation statements)

References 25 publications

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“…Time in target glucose range was higher with the AHCL system than with the Medtronic 670G, while time in hypoglycaemia was similar (Table 2). The AHCL system was associated with fewer system alerts, reduced Auto Mode exits and increased time spent in Auto Mode (86% vs 75%) [11].…”

Section: Commercially Available Closed-loop Systemsmentioning

confidence: 97%

New closed-loop insulin systems

2021

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Advances in diabetes technologies have enabled the development of automated closed-loop insulin delivery systems. Several hybrid closed-loop systems have been commercialised, reflecting rapid transition of this evolving technology from research into clinical practice, where it is gradually transforming the management of type 1 diabetes in children and adults. In this review we consider the supporting evidence in terms of glucose control and quality of life for presently available closed-loop systems and those in development, including dual-hormone closed-loop systems. We also comment on alternative ‘do-it-yourself’ closed-loop systems. We remark on issues associated with clinical adoption of these approaches, including training provision, and consider limitations of presently available closed-loop systems and areas for future enhancements to further improve outcomes and reduce the burden of diabetes management. Graphical abstract

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Section: Commercially Available Closed-loop Systemsmentioning

confidence: 97%

New closed-loop insulin systems

2021

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“…In die multinationale randomisierte Crossoverstudie FLAIR wurden 113 Personen mit T1D im Alter von 14–29 Jahren (Durchschnittsalter: 19 Jahre, HbA 1c : 7–11 %), die bisher entweder eine Insulinpumpe oder mehrfach tägliche Insulininjektionen verwendet hatten, aus akademischen Praxen in den USA und Europa eingeschlossen [ 9 ]. Nach einer Einarbeitungszeit der Teilnehmer wurden je die Hälfte entweder mit einem MiniMed™ 670G-Hybrid-Closed-Loop-System oder einer neuen, für Jugendliche und junge Erwachsene besonders angepassten Technologie mit mehreren algorithmischen Erweiterungen und Funktionen des MD-Logik-Algorithmus (MD: „message digest“) für die künstliche Bauchspeicheldrüse wie z.…”

Section: Diabetestechnologie Und Typ-1-diabetesunclassified

Diabetes Update 2021

Scherbaum

2021

Diabetologe

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“…The advanced system had a larger number of individuals reaching a TIR target of 70%, with up to a 3-fold increase compared to baseline versus the previous system's 2-fold increase. 240…”

Section: Evidence Basementioning

confidence: 99%

American Association of Clinical Endocrinology Clinical Practice Guideline: The Use of Advanced Technology in the Management of Persons With Diabetes Mellitus

et al. 2021

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automated insulin dosing continuous glucose monitoring continuous subcutaneous insulin infusion diabetes diabetes technology glucose sensors hybrid closed loop insulin pumps sensor-augmented pump low-glucose suspend predictive low-glucose suspend a b s t r a c t Objective: To provide evidence-based recommendations regarding the use of advanced technology in the management of persons with diabetes mellitus to clinicians, diabetes-care teams, health care professionals, and other stakeholders. Methods: The American Association of Clinical Endocrinology (AACE) conducted literature searches for relevant articles published from 2012 to 2021. A task force of medical experts developed evidence-based guideline recommendations based on a review of clinical evidence, expertise, and informal consensus, according to established AACE protocol for guideline development. Main Outcome Measures: Primary outcomes of interest included hemoglobin A1C, rates and severity of hypoglycemia, time in range, time above range, and time below range. Results: This guideline includes 37 evidence-based clinical practice recommendations for advanced diabetes technology and contains 357 citations that inform the evidence base.Recommendations: Evidence-based recommendations were developed regarding the efficacy and safety of devices for the management of persons with diabetes mellitus, metrics used to aide with the assessment of advanced diabetes technology, and standards for the implementation of this technology. Conclusions: Advanced diabetes technology can assist persons with diabetes to safely and effectively achieve glycemic targets, improve quality of life, add greater convenience, potentially reduce burden of Disclaimer: The American Association of Clinical Endocrinology medical guidelines for clinical practice are systematically developed statements to assist health care professionals in medical decision-making for specific clinical conditions. Most of the content herein is based on clinical evidence. In areas of uncertainty, or when clarification is required, expert opinion and professional judgment were applied.This guideline is a working document that reflects the state of the field at the time of publication. Because rapid changes are expected in this area, periodic revisions are inevitable. We encourage medical professionals to use this information in conjunction with their best clinical judgment. The presented recommendations may not be appropriate in all situations. Any decision by practitioners to apply these guidelines must be made considering local resources and individual patient circumstances.

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A comparison of two hybrid closed-loop systems in adolescents and young adults with type 1 diabetes (FLAIR): a multicentre, randomised, crossover trial

Cited by 224 publications

References 25 publications

New closed-loop insulin systems

New closed-loop insulin systems

Diabetes Update 2021

American Association of Clinical Endocrinology Clinical Practice Guideline: The Use of Advanced Technology in the Management of Persons With Diabetes Mellitus

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