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

APCam11 Consortium; AP@home Consortium; KidsAP Consortia

doi:10.2337/dc18-2625

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

APCam11 Consortium, AP@home Consortium, KidsAP Consortia

Division of Diabetes, Endocrinology & Gastroenterology (L5)

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Pages (from-to)	1344-1347
Number of pages	4
Journal	Diabetes Care
Volume	42
Issue number	7
Early online date	21 May 2019
DOIs	https://doi.org/10.2337/dc18-2625
Publication status	Published - Jul 2019

Keywords

Adolescent
Adult
Age Factors
Aged
Blood Glucose/drug effects
Blood Glucose Self-Monitoring/instrumentation
Child
Child, Preschool
Cross-Over Studies
Diabetes Mellitus, Type 1/blood
Dose-Response Relationship, Drug
Female
Humans
Hypoglycemic Agents/administration & dosage
Individuality
Infant
Insulin/administration & dosage
Insulin Infusion Systems
Male
Middle Aged
Multicenter Studies as Topic/statistics & numerical data
Randomized Controlled Trials as Topic/statistics & numerical data
Retrospective Studies
Young Adult

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.2337/dc18-2625

https://www.repository.cam.ac.uk/handle/1810/292141

Cite this

@article{9fa85a6b3f96450799f1fa1ecec619eb,

title = "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.",

keywords = "Adolescent, Adult, Age Factors, Aged, Blood Glucose/drug effects, Blood Glucose Self-Monitoring/instrumentation, Child, Child, Preschool, Cross-Over Studies, Diabetes Mellitus, Type 1/blood, Dose-Response Relationship, Drug, Female, Humans, Hypoglycemic Agents/administration & dosage, Individuality, Infant, Insulin/administration & dosage, Insulin Infusion Systems, Male, Middle Aged, Multicenter Studies as Topic/statistics & numerical data, Randomized Controlled Trials as Topic/statistics & numerical data, Retrospective Studies, Young Adult",

author = "{APCam11 Consortium} and {AP@home Consortium} and {KidsAP Consortia} and Klemen Dovc and Charlotte Boughton and Martin Tauschmann and Hood Thabit and Lia Bally and Allen, {Janet M} and Acerini, {Carlo L} and Sabine Arnolds and {de Beaufort}, Carine and Bergenstal, {Richard M} and Fiona Campbell and Amy Criego and Dunger, {David B} and Daniella Elleri and Evans, {Mark L} and Elke Fr{\"o}hlich-Reiterer and Sabine Hofer and Thomas Kapellen and Lalantha Leelarathna and Pieber, {Thomas R} and Birgit Rami-Merhar and Shah, {Viral N} and Judy Sibayan and Wilinska, {Malgorzata E} and Roman Hovorka",

note = "{\textcopyright} 2019 by the American Diabetes Association.",

year = "2019",

month = jul,

doi = "10.2337/dc18-2625",

language = "English",

volume = "42",

pages = "1344--1347",

journal = "Diabetes Care",

issn = "0149-5992",

publisher = "American Diabetes Association ",

number = "7",

}

TY - JOUR

T1 - Young Children Have Higher Variability of Insulin Requirements

T2 - Observations During Hybrid Closed-Loop Insulin Delivery

AU - APCam11 Consortium

AU - AP@home Consortium

AU - KidsAP Consortia

AU - Dovc, Klemen

AU - Boughton, Charlotte

AU - Tauschmann, Martin

AU - Thabit, Hood

AU - Bally, Lia

AU - Allen, Janet M

AU - Acerini, Carlo L

AU - Arnolds, Sabine

AU - de Beaufort, Carine

AU - Bergenstal, Richard M

AU - Campbell, Fiona

AU - Criego, Amy

AU - Dunger, David B

AU - Elleri, Daniella

AU - Evans, Mark L

AU - Fröhlich-Reiterer, Elke

AU - Hofer, Sabine

AU - Kapellen, Thomas

AU - Leelarathna, Lalantha

AU - Pieber, Thomas R

AU - Rami-Merhar, Birgit

AU - Shah, Viral N

AU - Sibayan, Judy

AU - Wilinska, Malgorzata E

AU - Hovorka, Roman

PY - 2019/7

Y1 - 2019/7

N2 - 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.

AB - 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.

KW - Adolescent

KW - Adult

KW - Age Factors

KW - Aged

KW - Blood Glucose/drug effects

KW - Blood Glucose Self-Monitoring/instrumentation

KW - Child

KW - Child, Preschool

KW - Cross-Over Studies

KW - Diabetes Mellitus, Type 1/blood

KW - Dose-Response Relationship, Drug

KW - Female

KW - Humans

KW - Hypoglycemic Agents/administration & dosage

KW - Individuality

KW - Infant

KW - Insulin/administration & dosage

KW - Insulin Infusion Systems

KW - Male

KW - Middle Aged

KW - Multicenter Studies as Topic/statistics & numerical data

KW - Randomized Controlled Trials as Topic/statistics & numerical data

KW - Retrospective Studies

KW - Young Adult

U2 - 10.2337/dc18-2625

DO - 10.2337/dc18-2625

M3 - Article

C2 - 31221700

SN - 0149-5992

VL - 42

SP - 1344

EP - 1347

JO - Diabetes Care

JF - Diabetes Care

IS - 7

ER -

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

Abstract

Keywords

UN SDGs

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