Pre‐school and school‐aged children benefit from the switch from a sensor‐augmented pump to an AndroidAPS hybrid closed loop: A retrospective analysis

Abstract

Objective: Data on closed loop systems in young children with type 1 diabetes (T1D) are limited. We tested the efficacy and safety of an open-source, do-it-yourself automated insulin delivery system AndroidAPS in preschool and school-aged children.Research Design and Methods: This retrospective study analyzed diabetes control in 18 preschool (3-7 years) and 18 school-aged children (8-14 years) with T1D who switched from a sensor-augmented pump (SAP) to AndroidAPS. We compared the CGM parameters and HbA1c levels 3 months before and 6 months after the initiation of AndroidAPS therapy and evaluated frequency of severe adverse events during AndroidAPS use, the most frequent reasons for its interruption, and the experience and psychosocial benefits of AndroidAPS use.Results: General glycemic control was significantly improved after the switch from SAP to AndroidAPS. Time in range (TIR) increased in both preschool (70.8%-78.6%, p = 0.004) and school-aged children (77.2%-82.9%, p < 0.001), whereas HbA1c levels decreased (preschool children 53.8-48.5 mmol/mol, p < 0.001; school-aged children 52.6-45.1 mmol/mol, p = 0.001). Time spent in range of 3.0-3.8 mmol/L increased slightly in school children (2.6%-3.8%, p = 0.040), but not in preschool children (3.0%-3.0%, p = 0.913). Time spent at <3 mmol/L remained unchanged in both preschool (0.95%-0.67%, p = 0.432) and school-aged children (0.8%-0.8%, p = 1.000).No episodes of severe hypoglycemia or DKA and significant improvement of quality of life were reported by AndroidAPS users.Conclusions: AndroidAPS seems effective for T1D control both in preschool and school-age children but further validation by prospective studies is necessary.

The Impact of Hypo- and Hyperglycemia on Cognition and Brain Development in Young Children with Type 1 Diabetes

“…In order to try to improve their children’s and family’s quality of life, more parents are implementing do-it-yourself closed-loop systems. A recent study [67] retrospectively examined the efficacy and safety of such a system, AndroidAPS, in preschool and school-aged children (2 groups, 3–7 years and 8–14 years). After switching from SAP to AndroidAPS, both groups showed increased TIR and lower HbA1C levels, with no episodes of severe hypoglycemia or DKA.…”

Empfehlungen zur Diabetes-Behandlung mit automatischen Insulin-Dosierungssystemen

“…Die Personen, die mit AID wahrscheinlich am zufriedensten sein werden, sind diejenigen, die die mentale Belastung durch das Anpassen der Einstellungen und das Mikromanagement hoher Glukosewerte reduzieren möchten. Im Gegensatz dazu sind Menschen, die über eine detaillierte Kenntnis ihrer Einstellungsparameter verfügen und mit den verbundenen Risiken einer Behandlung mit einem Open-Source-System vertraut sind [16,18], oft von der fehlenden Flexibilität kommerzieller Systeme enttäuscht und erreichen mit offenen Systemen zum Teil bessere Ergebnisse [40,41,42]. Insgesamt erreichen Menschen, die bereits bei Umstellung auf AID eine gute Zeit im Zielbereich haben, die insgesamt besten Ergebnisse mit AID.…”

Efficient Closed Loop Simulation of Do-It-Yourself Artificial Pancreas Systems

“…Indeed, a number of studies based on real-world experiences and CGM data provided by users have shown, that the DIY APS algorithms keep blood glucose (BG) values stable, especially at night; also, participants reported a significant increase in quality of life. [19][20][21][22][23][24][25][26][27][28] Nevertheless, more data obtained in randomized controlled trials is needed to support the strength of evidence. Another drawback of missing approval procedures is that the algorithms are not developed and tested following standardized procedures and quality management guidelines, that is, new versions or features always carry the risk of potentially dangerous errors.…”