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Time Spent in Hypoglycemia According to Age and Time of Day: Observations During Closed-Loop Insulin Delivery

Heba Alwan1,2,3, Julia Ware1,4, Charlotte K Boughton1,5

  • 1Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom.

Diabetes Technology & Therapeutics
|May 25, 2023
PubMed

Insights

Pediatric patients with type 1 diabetes experience more hypoglycemia during closed-loop insulin delivery. Hypoglycemia risk is lowest overnight for all age groups.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pediatric Diabetes Management

Background:

  • Type 1 diabetes management requires careful glucose control.
  • Closed-loop insulin delivery systems aim to improve glycemic outcomes.
  • Understanding age-related differences in hypoglycemia during automated insulin delivery is crucial.

Purpose of the Study:

  • To evaluate if time spent in hypoglycemia during closed-loop insulin delivery varies by age group.
  • To determine if time of day influences hypoglycemia risk in different age demographics.

Main Methods:

  • Retrospective analysis of hybrid closed-loop study data.
  • Inclusion of participants with type 1 diabetes across four age groups: young children (2-7), children/adolescents (8-18), adults (19-59), and older adults (≥60).
  • Primary outcome measured: percentage of time spent with blood glucose <3.9 mmol/L (<70 mg/dL).

Main Results:

  • Time in hypoglycemia was highest in children and adolescents (4.4%) and very young children (4.0%).
  • Adults (2.7%) and older adults (1.8%) experienced less time in hypoglycemia.
  • Hypoglycemia was significantly lower during nighttime (midnight-05:59) compared to daytime across all age groups (P < 0.001).

Conclusions:

  • Pediatric populations (young children, children, and adolescents) exhibit the highest burden of hypoglycemia during closed-loop insulin delivery.
  • Overnight periods consistently show the lowest risk of hypoglycemia across all studied age groups.
  • Age and time of day are significant factors influencing hypoglycemia risk in type 1 diabetes managed with closed-loop systems.

Keywords:
Artificial pancreasClosed-loop insulin deliveryInsulin pump therapyRandomized trialType 1 diabetes

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