Are all HCL systems the same? Long term outcomes of three HCL systems in children with type 1 diabetes: real-life registry-based study
Abstract
Objective: To compare parameters of glycemic control among three types of hybrid closed loop (HCL) systems in children with T1D (CwD) using population-wide data from the national pediatric diabetes registry ČENDA. Methods: CwD aged 12 months and monitored by CGM>70% of the time were included. HbA1c, times in glycemic rangers, and Glycemia Risk Index (GRI) were used for cross-sectional comparison between the HCL systems.
Results: Data from 512 CwD were analyzed. 780G, Control-IQ and AAPS were used by 217 (42,4%), 211 (41,2%), and 84 (16.4%) CwD, respectively. The lowest HbA1c value was observed in the AAPS group (44mmol/mol; OQR 8.0, p<0.0001 vs any other group), followed by Control-IQ and 780G groups (48 (IQR 11) and 52 (OQR 10) mmol/mol, respectively). All of the systems met the recommended criteria for time in range (78% in AAPS, 76% in 780G, and 75% in Control-IQ users). CwD using AAPS spent significantly more time in hypoglycemia (5% vs 2% in 780G and 3% in Control-IQ) and scored the highest GRI (32, IQR 17). The lowest GRI (27, IQR 15) was seen in 780G users. Conclusion: Although all HCL systems proved effective in maintaining recommended long-tserm glycemic control, we observed differences that illustrate strengths and weaknesses of particular systems. Our fingings could help in individualizing the choice of HCL systems.