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Closed-Loop Insulin Delivery in Children <7 Years of Age

Closed-Loop Insulin Delivery in Children <7 Years of Age. Closed-Loop Insulin Therapy (CLT). Background Children at increased risk of hypoglycemia, especially at night Neurocognitive effects can result Children have unpredictable eating patterns and erratic activity levels by insulin pump.

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Closed-Loop Insulin Delivery in Children <7 Years of Age

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  1. Closed-Loop Insulin Delivery in Children <7 Years of Age Closed-Loop Insulin Therapy (CLT) • Background • Children at increased risk of hypoglycemia, especially at night • Neurocognitive effects can result • Children have unpredictable eating patterns and erratic activity levels • by insulin pump

  2. Closed-Loop Insulin Delivery in Children <7 Years of Age Objective • The aim of CLT is to achieve tight glucose control and reduce risk of hypoglycemia • CLT combines glucose sensing and insulin-delivery components with real-time glucose-responsive insulin administration • Disposable sensor measures interstitial glucose levels • Algorithm controls rapid-acting insulin analog delivery • The aim of this study as to test CLT in young children with diabetes

  3. Closed-Loop Insulin Delivery in Children <7 Years of Age Design and Methods • Children <7 years with T1DM >6 months treated with insulin pump therapy for >6 weeks (n=10) • Randomized crosss-over trial comparing CLT with open-loop therapy • Two control periods: overnight and daytime • Target blood glucose: 10 PM-6 AM – 150 mg/dL; 6 AM-noon – 120 mg/dL

  4. Closed-Loop Insulin Delivery in Children <7 Years of Age Study Design

  5. Closed-Loop Insulin Delivery in Children <7 Years of Age • Results • Time at night target increased with CLT but not significantly different from open-loop • Time in overnight extreme hyperglycemia and total glycemic excursion significantly reduced • No difference in number of interventions for hypoglycemia

  6. Closed-Loop Insulin Delivery in Children <7 Years of Age

  7. Closed-Loop Insulin Delivery in Children <7 Years of Age • Conclusions • CLT decreased the degree of noturnal hyperglycemia in young children without increasing the incidence of hypoglycemia • CLT improved prelunch blood glucose • CLT has the potential to improve diabetes care in very young children

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