We report a real-world evaluation of the first commercially approved automated insulin delivery (AID) system, MiniMed 670G (670G), and open source-automated insulin delivery (OS-AID) systems. This was undertaken as a retrospective observational study in adults with type 1 diabetes using AID systems for 6 months or longer in a publicly funded health service using clinically validated data. Sixty-eight adults (38 670G, 30 OS-AID systems) were included. OS-AID system users were younger, had a shorter diabetes duration and a higher education status. OS-AID systems displayed a significantly better change in HbA1c (median À0.9% [À0.4%, À1.1%] vs. À0.1% [IQR À0.7%, 0.2%], P = .004) and time in range 3.9-10 mmol/L (mean 78.5%, SD ± 12.0% vs. 68.2% ± 14.7%, P = .024) compared with 670G. Both systems showed minimal hypoglycaemia, with OS-AID systems revealing significantly improved secondary outcomes of mean glucose and percentage of time more than 10 mmol/L, with a higher percentage of time of less than 3 mmol/L. OS-AID system users displayed improved glycaemic outcomes with no clinical safety concerns compared with 670G, although higher weight-adjusted insulin dose and weight gain were noted. The study highlights key differences in OS-AID system user characteristics that are important for interpreting real-world findings from recent OS-AID system studies.

ObjectiveCatatonia is a debilitating psychomotor disorder. Previous neuroimaging studies have used small samples with inconsistent results. We aimed to describe the structural neuroradiological abnormalities in clinical MRI brain scans of patients with catatonia and compare them to psychiatric inpatients without catatonia. We report the largest study of catatonia neuroimaging to date. MethodsIn this retrospective case-control study, neuroradiological reports of psychiatric inpatients who had undergone MRI brain scans for clinical reasons were examined. Abnormalities were classified by lateralisation, localisation and pathology. The primary analysis was prediction of catatonia by the presence of an abnormal MRI scan, adjusted for age, sex, Black ethnicity and psychiatric diagnosis. ResultsScan reports from 79 patients with catatonia and 711 other psychiatric inpatients were obtained. Mean age (SD) in the cases was 36.4 years (17.3) and 44.5 (19.9) in the comparison group. Radiological abnormalities were reported in 27 out of 79 cases (34.2%) and in 338 out of 711 in the comparison group (47.5%), OR 0.57 (0.35 to 0.93), aOR 1.11 (0.58 to 2.14). Among the cases, most abnormal scans had bilateral abnormalities (n=23, 29.1%), involved the forebrain (25, 31.6%) and involved atrophy (17, 21.5%). ConclusionsPatients with catatonia are commonly reported to have brain MRI abnormalities, which largely consist of diffuse cerebral atrophy rather than focal lesions, but there is no evidence that these abnormalities are more common than in other psychiatric inpatients undergoing neuroimaging, after adjustment for demographic variables. Study limitations include a heterogeneous control group and selection bias in requesting scans.

No abstract

No abstract