Valentino Cherubini1, Ivana Rabbone2, Maria Giulia Berioli3, Sara Giorda4,5, Donatella Lo Presti6, Giulio Maltoni7, Chiara Mameli8, Marco Marigliano9, Monica Marino1, Nicola Minuto10, Enza Mozzillo11, Elvira Piccinno12, Barbara Predieri13, Carlo Ripoli14, Riccardo Schiaffini15, Andrea Rigamonti16, Giuseppina Salzano17, Davide Tinti4, Sonia Toni18, Angela Zanfardino19, Andrea Enzo Scaramuzza20, Rosaria Gesuita21. 1. Department of Women's and Children's Health, G. Salesi Hospital, Ancona, IT. 2. Department of Health and Science, University of Piemonte Orientale, Novara, IT. 3. Department of Pediatrics, University of Perugia, IT. 4. Department of Pediatrics, University of Torino, IT. 5. Adapted Training and Performance Research Group, School of Exercise and Sport Sciences, University of Turin, Turin, Italy. 6. Department of Pediatrics, University of Catania, IT. 7. Pediatric Unit, IRCCS, Azienda Ospedaliero-Universitaria, Bologna, IT. 8. Department of Pediatrics, Università di Milano, Buzzi Children's Hospital, Milan, IT. 9. Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, IT. 10. Pediatric Clinic, IRCCS G. Gaslini, Genoa, IT. 11. Department of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, University of Naples Federico II, Naples, IT. 12. Metabolic Diseases and Diabetology, Children's Hospital Giovanni XXIII, Bari, IT. 13. Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, IT. 14. Department of Pediatrics and Microcythemia, ARNAS G. Brotzu, Cagliari, Italy. 15. Diabetes Unit, Pediatric Hospital Bambino Gesù, Rome, IT. 16. Department of Pediatrics, Diabetes Research Institute, San Raffaele Institute, Milan, IT. 17. Department of Human Pathology in adult and developmental age, University of Messina, IT. 18. Pediatric Endocrinology and Diabetology Unit, Meyer Children's Hospital, Florence, IT. 19. Regional Center of Pediatric Diabetology, University of Campania "L. Vanvitelli", Naples, IT. 20. Department of Pediatrics, ASST Cremona, IT. 21. Centre of Epidemiology and Biostatistics, Polytechnic University of Marche, Ancona, IT.
Abstract
AIM: Education maximizes the benefits of new diabetes technology. Here we evaluated the impact of a virtual educational camp (vEC) on glucose control in children and adolescents with type 1 diabetes using a closed-loop control (CLC) system. MATERIALS AND METHODS: This was a prospective multicenter study of children and adolescents with type 1 diabetes using the Tandem Basal-IQ™ system. Insulin pumps were upgraded to Control-IQ™, and children and their parents participated in a three-day multidisciplinary vEC. Clinical data, glucose metrics, and HbA1c were evaluated over the 12 weeks prior to the Control-IQ update and over the 12 weeks after the vEC. RESULTS: Forty-three children and adolescents (aged 7-16 years) with type 1 diabetes and their families participated in the vEC. The median percentage of time in target range (70-180 mg/dL; TIR) increased from 64% (interquartile range [IQR] 56-73) with Basal-IQ to 76% (IQR 71-81) with Control-IQ (p < 0.001). After the vEC, over 75% of participants achieved TIR >70%. The percentage of time between 180-250 mg/dL and above 250 mg/dL decreased by 5% (p < 0.01) and 6% (p < 0.01), respectively, while the time between 70-54 mg/dL and below 54 mg/dL remained low and unaltered. HbA1c decreased by 0.5% (p < 0.01). There were no diabetic ketoacidosis or severe hypoglycemia episodes. CONCLUSIONS: In this study of children managing their diabetes in the real-world setting, over 75% of children who participated in a vEC after starting a CLC system could obtain and maintain a TIR >70%. The vEC was feasible and resulted in a significant and persistent improvement in TIR in children and adolescents with type 1 diabetes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
AIM: Education maximizes the benefits of new diabetes technology. Here we evaluated the impact of a virtual educational camp (vEC) on glucose control in children and adolescents with type 1 diabetes using a closed-loop control (CLC) system. MATERIALS AND METHODS: This was a prospective multicenter study of children and adolescents with type 1 diabetes using the Tandem Basal-IQ™ system. Insulin pumps were upgraded to Control-IQ™, and children and their parents participated in a three-day multidisciplinary vEC. Clinical data, glucose metrics, and HbA1c were evaluated over the 12 weeks prior to the Control-IQ update and over the 12 weeks after the vEC. RESULTS: Forty-three children and adolescents (aged 7-16 years) with type 1 diabetes and their families participated in the vEC. The median percentage of time in target range (70-180 mg/dL; TIR) increased from 64% (interquartile range [IQR] 56-73) with Basal-IQ to 76% (IQR 71-81) with Control-IQ (p < 0.001). After the vEC, over 75% of participants achieved TIR >70%. The percentage of time between 180-250 mg/dL and above 250 mg/dL decreased by 5% (p < 0.01) and 6% (p < 0.01), respectively, while the time between 70-54 mg/dL and below 54 mg/dL remained low and unaltered. HbA1c decreased by 0.5% (p < 0.01). There were no diabetic ketoacidosis or severe hypoglycemia episodes. CONCLUSIONS: In this study of children managing their diabetes in the real-world setting, over 75% of children who participated in a vEC after starting a CLC system could obtain and maintain a TIR >70%. The vEC was feasible and resulted in a significant and persistent improvement in TIR in children and adolescents with type 1 diabetes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Authors: Marco Marigliano; Andrea E Scaramuzza; Riccardo Bonfanti; Ivana Rabbone; Riccardo Schiaffini; Sonia Toni; Valentino Cherubini Journal: JAMA Netw Open Date: 2022-08-01