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

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.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Dovc K,Boughton C,Tauschmann M,Thabit H,Bally L,Allen JM,Acerini CL,Arnolds S,de Beaufort C,Bergenstal RM,Campbell F,Criego A,Dunger DB,Elleri D,Evans ML,Fröhlich-Reiterer E,Hofer S,Kapellen T,Leelarathna L,Pieber T

doi

10.2337/dc18-2625

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

1344-1347

issue

7

eissn

0149-5992

issn

1935-5548

pii

dc18-2625

journal_volume

42

pub_type

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