Related Experiment Video
Updated: May 3, 2026
12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
18.8K
Eighteen-Month Hybrid Closed-Loop Use in Very Young Children With Type 1 Diabetes: A Single-Arm Multicenter Trial
Julia Ware1,2, Janet M Allen1,2, Charlotte K Boughton1,3
1Institute of Metabolic Science-Metabolic Research Laboratories, University of Cambridge, Cambridge, U.K.
Diabetes Care
|October 17, 2024
Summary
Hybrid closed-loop (CL) therapy improved glycemic control in very young children with type 1 diabetes (T1D) for over 18 months. This advanced system demonstrated sustained efficacy and safety in managing T1D in this age group.
Area of Science:
- Pediatric Endocrinology
- Biomedical Engineering
- Diabetes Technology
Background:
- Type 1 diabetes (T1D) management in very young children presents unique challenges.
- Hybrid closed-loop (CL) systems offer a potential solution for improved glycemic control.
- Longer-term data on CL therapy in this population are limited.
Purpose of the Study:
- To evaluate the extended safety and efficacy of hybrid CL therapy in children aged 1-7 years with T1D.
- To compare outcomes of CL therapy during an 18-month extension phase with initial sensor-augmented pump (SAP) and CL periods.
Main Methods:
- A multinational, randomized crossover trial was followed by an 18-month extension phase using CL therapy.
- Participants (n=49) aged 1-7 years with T1D continued CL therapy after a primary phase comparing CL with SAP.
- Outcomes including time in range (TIR) and HbA1c were compared between study periods.
Main Results:
- CL therapy extension phase showed significantly higher TIR (+8.4%) and lower HbA1c (-0.4%) compared to the primary SAP phase.
- Glycemic control metrics (HbA1c, TIR) remained stable and comparable between the CL extension and primary CL periods.
- Time in hypoglycemia was similar across all periods; two severe hypoglycemia events and one serious adverse device effect were reported.
Conclusions:
- The Cambridge hybrid CL system provides sustained glycemic control benefits for over 18 months in very young children with T1D.
- Hybrid CL therapy is a safe and effective option for managing T1D in preschool-aged children.
- Continued use of CL technology supports long-term improvements in diabetes management for pediatric patients.
Related Concept Videos
01:22Diabetes Mellitus: Overview and Type I Subtype
5.5K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
5.5K
01:22Diabetes Mellitus: Type 2 and Gestational
4.9K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
4.9K
01:16Insulin: Dosing Regimen and Adverse Effects
1.3K
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
1.3K
01:12Type I Diabetes I: Introduction
45
Type 1 diabetes mellitus is a chronic metabolic disorder characterized by an absolute deficiency of insulin resulting from the autoimmune destruction of pancreatic β-cells. Although it can occur at any age, it is most commonly diagnosed in childhood, adolescence, or early adulthood. The loss of insulin production impairs cellular glucose uptake, resulting in persistent hyperglycemia and necessitating lifelong insulin therapy.Autoimmune Destruction of β-CellsThe hallmark of type 1...
45
01:19Type I Diabetes III: Clinical Manifestations
26
Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the...
26
01:26Type II Diabetes I: Introduction
17
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance, in which target tissues such as the liver, muscle, and adipose tissue respond poorly to insulin. It is also associated with inadequate compensatory insulin secretion, where pancreatic β-cells fail to produce sufficient insulin. Together, these abnormalities lead to persistent hyperglycemia.EtiologyT2DM develops through a complex interaction of genetic predisposition and environmental or...
17