Klemen Dovc1,2, Charlotte Boughton1, Martin Tauschmann1,3, Hood Thabit1,4, Lia Bally1,5, Janet M Allen1,6, Carlo L Acerini1,6, Sabine Arnolds7, Carine de Beaufort8, Richard M Bergenstal9, Fiona Campbell10, Amy Criego9, David B Dunger1,6, Daniella Elleri11, Mark L Evans1,12, Elke Fröhlich-Reiterer13, Sabine Hofer14, Thomas Kapellen15, Lalantha Leelarathna4, Thomas R Pieber16, Birgit Rami-Merhar3, Viral N Shah17, Judy Sibayan18, Malgorzata E Wilinska1,6, Roman Hovorka19,6. 1. Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, U.K. 2. Department of Pediatric Endocrinology, Diabetes, and Metabolic Diseases, University Children's Hospital, University Medical Centre, Ljubljana, Slovenia. 3. Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria. 4. Manchester Diabetes Centre, Manchester University Hospitals National Health Service (NHS) Foundation Trust, Manchester, U.K. 5. Departments of Diabetes, Endocrinology, Clinical Nutrition, and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. 6. Department of Paediatrics, University of Cambridge, Cambridge, U.K. 7. Profil Institut fuer Stoffwechselforschung GmbH, Neuss, Germany. 8. DECCP, Clinique Pédiatrique/CH de Luxembourg, Luxembourg, Luxembourg. 9. International Diabetes Center at Park Nicollet, St. Louis Park, MN. 10. Department of Paediatric Diabetes, Leeds Children's Hospital, Leeds, U.K. 11. Royal Hospital for Sick Children, Edinburgh, U.K. 12. Department of Diabetes and Endocrinology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, U.K. 13. Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria. 14. Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria. 15. Division for Paediatric Diabetology, University of Leipzig, Leipzig, Germany. 16. Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria. 17. Barbara Davis Center for Diabetes, University of Colorado, Denver, CO. 18. Jaeb Center for Health Research, Tampa, FL. 19. Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, U.K. rh347@cam.ac.uk.
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.
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.
Authors: Michelle A Van Name; Marisa E Hilliard; Claire T Boyle; Kellee M Miller; Daniel J DeSalvo; Barbara J Anderson; Lori M Laffel; Stephanie E Woerner; Linda A DiMeglio; William V Tamborlane Journal: Pediatr Diabetes Date: 2017-04-21 Impact factor: 4.866
Authors: Martin Tauschmann; Janet M Allen; Katrin Nagl; Maria Fritsch; James Yong; Emily Metcalfe; Dominique Schaeffer; Muriel Fichelle; Ulrike Schierloh; Alena G Thiele; Daniela Abt; Harald Kojzar; Julia K Mader; Sonja Slegtenhorst; Nicole Barber; Malgorzata E Wilinska; Charlotte Boughton; Gianluca Musolino; Judy Sibayan; Nathan Cohen; Craig Kollman; Sabine E Hofer; Elke Fröhlich-Reiterer; Thomas M Kapellen; Carlo L Acerini; Carine de Beaufort; Fiona Campbell; Birgit Rami-Merhar; Roman Hovorka Journal: Diabetes Care Date: 2019-01-28 Impact factor: 19.112
Authors: Yue Ruan; Hood Thabit; Lalantha Leelarathna; Sara Hartnell; Malgorzata E Willinska; Sibylle Dellweg; Carsten Benesch; Julia K Mader; Manuel Holzer; Harald Kojzar; Mark L Evans; Thomas R Pieber; Sabine Arnolds; Roman Hovorka Journal: Diabetes Care Date: 2016-03-10 Impact factor: 19.112
Authors: Martin Tauschmann; Janet M Allen; Malgorzata E Wilinska; Hood Thabit; Carlo L Acerini; David B Dunger; Roman Hovorka Journal: Diabetes Care Date: 2016-09-09 Impact factor: 19.112
Authors: Susanna Wiegand; Klemens Raile; Thomas Reinehr; Sabine Hofer; Andrea Näke; Wolfgang Rabl; Reinhard W Holl Journal: Eur J Endocrinol Date: 2008-04 Impact factor: 6.664
Authors: Martin Tauschmann; Hood Thabit; Lia Bally; Janet M Allen; Sara Hartnell; Malgorzata E Wilinska; Yue Ruan; Judy Sibayan; Craig Kollman; Peiyao Cheng; Roy W Beck; Carlo L Acerini; Mark L Evans; David B Dunger; Daniela Elleri; Fiona Campbell; Richard M Bergenstal; Amy Criego; Viral N Shah; Lalantha Leelarathna; Roman Hovorka Journal: Lancet Date: 2018-10-03 Impact factor: 202.731
Authors: Erin C Cobry; Tyler Reznick-Lipina; Laura Pyle; Robert Slover; John F Thomas; Guy Todd Alonso; Raj Paul Wadwa Journal: Diabetes Technol Ther Date: 2022-01 Impact factor: 6.118
Authors: Julia Fuchs; Janet M Allen; Charlotte K Boughton; Malgorzata E Wilinska; Ajay Thankamony; Carine de Beaufort; Fiona Campbell; James Yong; Elke Froehlich-Reiterer; Julia K Mader; Sabine E Hofer; Thomas M Kapellen; Birgit Rami-Merhar; Martin Tauschmann; Korey Hood; Barbara Kimbell; Julia Lawton; Stephane Roze; Judy Sibayan; Nathan Cohen; Roman Hovorka Journal: BMJ Open Date: 2021-02-12 Impact factor: 2.692
Authors: Gregory P Forlenza; Laya Ekhlaspour; Linda A DiMeglio; Larry A Fox; Henry Rodriguez; Dorothy I Shulman; Kevin B Kaiserman; David R Liljenquist; John Shin; Scott W Lee; Bruce A Buckingham Journal: Pediatr Diabetes Date: 2022-01-31 Impact factor: 3.409