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Young Children Have Higher Variability of Insulin Requirements: Observations During Hybrid Closed-Loop Insulin Delivery.

Accepted version
Peer-reviewed

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Type

Article

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Authors

Dovc, Klemen 
Boughton, Charlotte 
Tauschmann, Martin 
Thabit, Hood 

Abstract

OBJECTIVE: To quantify age-related variability of insulin needs during day and night closed-loop insulin delivery. RESEARCH DESIGN AND METHODS: We retrospectively analyzed data from hybrid closed-loop studies involving young children (1-6 years old, n = 20), children (7-12 years, n = 21), adolescents (13-17 years, n = 15), and adults (>18 years, n = 58) with type 1 diabetes. The coefficient of variation quantified variability of insulin needs during 3 weeks of unrestricted-living hybrid closed-loop use. RESULTS: Data from 2,365 nights and 2,367 days in 114 participants were analyzed. The coefficient of variation of insulin delivery was higher in young children compared with adults (mean difference at nighttime 10.7 percentage points [95% CI 2.9-18.4], P = 0.003; daytime 6.4 percentage points [95% CI 2.0-10.9], P = 0.002) and compared with adolescents (mean difference at nighttime 10.2 percentage points [95% CI 0.0-20.4], P = 0.049; daytime 7.0 percentage points [95% CI 1.1-12.8], P = 0.014). CONCLUSIONS: Diabetes management in young children is complicated by higher variability in insulin requirements, supporting fast-track clinical practice adoption of closed-loop in this vulnerable population.

Description

Keywords

Adolescent, Adult, Age Factors, Aged, Blood Glucose, Blood Glucose Self-Monitoring, Child, Child, Preschool, Cross-Over Studies, Diabetes Mellitus, Type 1, Dose-Response Relationship, Drug, Female, Humans, Hypoglycemic Agents, Individuality, Infant, Insulin, Insulin Infusion Systems, Male, Middle Aged, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, Retrospective Studies, Young Adult

Journal Title

Diabetes Care

Conference Name

Journal ISSN

0149-5992
1935-5548

Volume Title

42

Publisher

American Diabetes Association

Rights

All rights reserved
Sponsorship
European Commission Horizon 2020 (H2020) Societal Challenges (731560)
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
Juvenile Diabetes Research Foundation Ltd (JDRF) (2-SRA-2014-256-M-R)
Wellcome Trust (100574/Z/12/Z)
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK085621)
European Commission (247138)
Medical Research Council (G0600717)
Medical Research Council (G0600717/1)