Thread by @AKoutnik

#Type1Diabetes Closed-Loop Technology & Glycemic Control:


New study in VERY young children & closed loop (🧵 below):
1/n

🧵#Type1Diabetes Closed-Loop in VERY-young children:
nejm.org/doi/full/10.10…

-PEDAP Trial: 102 Children (2-6y/age)
-Control-IQ CL (@TandemDiabetes: AI+pump+CGM) VS CGM-Only
-Baseline: Better than average glycemic control

Results?
2/n

@TandemDiabetes T1D Closed-Loop Results:
⬆️Time-In-Range (% 70-180): 56.7 -> 69.3%
⬇️Mean Glucose: 173 -> 155mg/dL
⬇️HbA1c: 7.5 -> 7.0%
⬇️Severe Hyperglycemia (% >250mg/dL): 56.7 -> 69.3%
↔️ Hypoglycemia (<70 or <56mg/dL)

What about time in normoglycemia?
3/n

@TandemDiabetes Type-1 Diabetes Closed-Loop Results:

Time-in-Tight Range (70-140mg/dL):
-Close-Loop: 48% (52% OUT of normal range)
-Standard of Care: 35% (65% OUT of normal range)

Comparison to other trials?
4/n

@TandemDiabetes T1D Closed-Loop Trials Comparison:

VERY similar. CL ⬆️ glycemic control ✅...but patients improve mostly WHEN NOT EATING (>90% time: 70-180mg/dL).

See circadian glucose patterns across trials and prior thread on closed-loop:

https://twitter.com/AKoutnik/status/1567852686510276608

What does this teach us?
5/n

@TandemDiabetes Take Homes:
@TandemDiabetes closed-loop in #type1diabetes kids: Closed-Loop > SOC
⬆️TIR
⬇️Mean Glucose
⬇️HbA1c
⬇️Severe Hypers
↔️ Hypos

🚨but...T1D kids with THE BEST TECH spend 52%/day NOT in normoglycemia...to improve, we MUST consider why 1am to 8am ⬆️⬆️⬆️glycemia? 🍽️
End🧵

@TandemDiabetes Video summary of #Type1Diabetes Closed-Loop in VERY-young children (PEDAP Trial):

Study Link: nejm.org/doi/full/10.10…

@TandemDiabetes @JimJohnsonSci @MCRiddell1 @DikemanDave @DIgudesman @glycogentheory @NEJM @DominicDAgosti2 @danamlewis @NupurLalvani @reboundhigh @DrBobGabbay @davidludwigmd @nejm @AnnChildersMD @DanielJDrucker