Excellent Glycemic Control Maintained by Open-Source Hybrid Closed-Loop AndroidAPS During and After Sustained Physical Activity
Abstract
Objective: Officially licensed hybrid closed-loop systems are not currently available worldwide; therefore, open-source systems have become increasingly popular. Our aim was to assess the safety, feasibility, and efficacy of an open-source hybrid closed-loop system (AndroidAPS) versus SmartGuard((R)) technology for day-and-night glucose control in children under extreme sports conditions.
Research Design and Methods: Twenty-two children (16 girls, 6-15 years of age, median HbA1c 569mmol/mol) were enrolled in this pivotal winter sports camp study. The participants were divided into two groups using either the AndroidAPS or SmartGuard technology.
Physical exertion was represented by all-day alpine skiing. The primary endpoints were mean glucose level, time below the threshold of 3.9mmol/L, and time within the target range of 3.9 to 10mmol/L.
Results: The children using the AndroidAPS had significantly lower mean glycemia levels (7.2 +/- 2.7 vs. 7.7 +/- 2.8mmol/L; 129.6 +/- 49 vs. 138.6 +/- 50mg/dL, P3 days)]. No episodes of severe hypoglycemia or other serious adverse events were noted.
Conclusions: This pilot study showed that the AndroidAPS system was a safe and feasible alternative to the SmartGuard Technology.