T1D Loopers Spend More Time “In Range” Than Peers

A study in the United States by the New England Journal of Medicine has found that people living with Type 1 Diabetes, using a closed-loop system spend an average of 2.6 more hours a day in their target glucose range compared to their peers using a sensor-augmented pump.

Researchers also found that the glycated hemoglobin level of patients using the closed-loop system improved during the study. Conversely, on average patients in the control group experienced no change, according to the study, which was funded by the National Institute of Diabetes and Digestive and Kidney Diseases.

During the six-month trial, participants that used the closed-loop system increased time in their target glucose level from 61±17% at baseline to 71±12%. However, the control group, which used the sensor-augmented pump, on average had no gains from baseline. 

“The percentage of time that glucose was in the target range of 70 to 180 mg per deciliter over the six-month period, as measured by continuous glucose monitoring, was 11 percentage points higher among patients with the closed-loop system than among those with a sensor-augmented pump, an advantage that amounted to 2.6 hours per day,” researchers said.  

Scientists also found that during the day, 70% of participants in the closed-loop system group were in the glucose level target range, and 59% of the control group were in this range. At night, 76% of the closed-loop system users and 59% of control group were in the target range. 

The authors of the report noted that this improvement impacted closed-loop system users from a variety of demographics. 

“The percentage of time that the blood glucose level was within the target range of 70 to 180 mg per deciliter or below 70 mg per deciliter consistently favored the closed-loop system across a broad range of baseline characteristics, including age, sex, body-mass index, income, educational level, insulin pump or injection use, previous use of a continuous glucose monitor and glycated hemoglobin level, and the results were consistent across the seven clinical centers,” researchers wrote. 

In addition to target range, researchers reported the adjusted difference in glycated hemoglobin levels after six-months was roughly a third of a percentage point lower in patients with the closed-loop system, which analysis revealed to be a significant decline. 

The study included 168 participants with Type 1 diabetes between the ages of 14 to 71. Participants were randomly assigned a group, with two-thirds of participants sorted into the closed-loop system and one third into the control group. 

The amount of time that patients have lived with diabetes ranged from one year to 62 years. Participants’ baseline glycated hemoglobin ranged from 5.4 to 10.6%. All of the participants finished the trial. Researchers reported a 100% follow up visits and 99.9% of telephone contacts were completed. 

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