Impact of Advanced Hybrid Closed-Loop on Youth with High-Risk Type 1 Diabetes Using Multiple Daily Injections

Abstract

<p> </p> <p>Objective: To evaluate glycemic outcomes in youth (aged 13–25 years) with type 1 diabetes and high-risk glycemic control [HbA1c ≥ 8.5% (69 mmol/mol)] on multiple daily injections (MDI) after transitioning to advanced hybrid closed-loop (AHCL) therapy. </p> <p>Research Design and Methods: This prospective 3-month single-arm, dual-center study enrolled 20 participants, and all completed the study. </p> <p>Results: HbA1c decreased from 10.5 ± 2.1% (91.2 ± 22.8 mmol/mol) at baseline to 7.6 ± 1.1% (59.7 ± 11.9 mmol/mol) and time spent in target range 70–180 mg/dL (3.9–10.0 mmol/L) increased from 27.6 ± 13.2% at baseline, to 66.5 ± 9.8% after 3 months of AHCL. Two episodes of diabetic ketoacidosis attributed to infusion set failure occurred. </p> <p>Conclusions: AHCL has the potential to improve suboptimal glycemia in youth with type 1 diabetes previously on MDI.</p>