A Meta-Analysis of Randomized Trial Outcomes for the t:slim X2 Insulin Pump with Control-IQ Technology in Youth and Adults from Age 2 to 72

Beck, Roy W.; Kanapka, Lauren G.; Breton, Marc D.; Brown, Sue A.; Wadwa, R. Paul; Buckingham, Bruce A.; Kollman, Craig; Kovatchev, Boris

doi:10.1089/dia.2022.0558

Cited by 43 publications

(12 citation statements)

References 17 publications

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“…Beck and cols. conducted a thorough meta-analysis using individual patient data but did not perform a systematic review, which may have introduced some bias in the generalization of results ( 38 ). We focused on children and adolescents aged 2 to 18 years with a diagnosis of T1D.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of the hybrid closed-loop insulin delivery system in children and adolescents with type 1 diabetes: a meta-analysis with trial sequential analysis

Ferreira,

Trevisan,

Pasqualotto

et al. 2024

Archives of Endocrinology and Metabolism

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The aim of this study was to assess the efficacy and safety of hybrid closed-loop (HCL) systems for insulin delivery in children and adolescents with type 1 diabetes (T1D). We searched Embase, PubMed, and Cochrane Library for randomized controlled trials (RCTs) published until March 2023 comparing the HCL therapy with control therapies for children and adolescents with T1D. We computed weighted mean differences (WMDs) for continuous outcomes and risk ratios (RRs) with 95% confidence intervals (CIs) for binary endpoints. Four RCTs and 501 patients were included, of whom 323 were randomized to HCL therapy. Compared with control therapies, HCL significantly improved the period during which glucose level was 70-180 mg/dL (WMD 10.89%, 95% CI 8.22-13.56%) and the number of participants with glycated hemoglobin (HbA1c) level < 7% (RR 2.61, 95% CI 1.29-5.28). Also, HCL significantly reduced the time during which glucose level was > 180 mg/dL (WMD -10.46%, 95% CI -13.99 to -6.93%) and the mean levels of glucose (WMD -16.67 mg/dL, 95% CI -22.25 to -11.09 mg/ dL) and HbA1c (WMD -0.50%, 95% CI -0.68 to -0.31). There were no significant differences between therapies regarding time during which glucose level was < 70 mg/dL or <54 mg/dL or number of episodes of ketoacidosis, hyperglycemia, and hypoglycemia. In this meta-analysis, HCL compared with control therapies was associated with improved time in range and HbA1c control in children and adolescents with T1D and a similar profile of side effects. These findings support the efficacy of HCL in the treatment of T1D in this population.

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Section: Discussionmentioning

confidence: 99%

Efficacy of the hybrid closed-loop insulin delivery system in children and adolescents with type 1 diabetes: a meta-analysis with trial sequential analysis

Ferreira,

Trevisan,

Pasqualotto

et al. 2024

Archives of Endocrinology and Metabolism

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“…For instance, randomized controlled studies ( 8 , 9 ) and real-world evidence ( 10 , 11 ) have demonstrated that users of the MiniMed 780G (MM780G) advanced hybrid closed-loop (AHCL) system can achieve an average TIR >80% without increased risk of hypoglycemia, when users consistently use optimal system settings. Other systems have also reported good TIR ( 12 , 13 ). Here, we report on a comprehensive study of TITR in real-world users of the MM780G system with T1D.…”

Section: Introductionmentioning

confidence: 89%

Time in Tight Glucose Range in Type 1 Diabetes: Predictive Factors and Achievable Targets in Real-World Users of the MiniMed 780G System

Castañeda,

Arrieta,

van den Heuvel

et al. 2023

Diabetes Care

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OBJECTIVE We studied time in tight range (TITR; 70–140 mg/dL) in real-world users of the MiniMed 780G system (MM780G). RESEARCH DESIGN AND METHODS CareLink Personal data were extracted (August 2020 to December 2022) to examine TITR and its relationship with time in range (TIR; 70–180 mg/dL), factors predicting higher TITR, and which TITR target is a reasonable treatment goal. RESULTS The 13,461 users (3,762 age ≤15 years and 9,699 age >15 years) showed an average TITR of 48.9% in those age ≤15 years and 48.8% in the older group (vs. TIR 71.2% and 73.9%, respectively). Consistent use of a glucose target (GT) of 100 mg/dL and active insulin time (AIT) of 2 h were the most relevant factors predicting higher TITR (P < 0.0001). In users consistently applying these optimal settings, TITR was 56.7% in those age ≤15 years and 57.0% in the older group, and the relative impact of these settings on TITR was 60% and 86% greater than that on TIR, respectively. TITRs of ∼45% (age ≤15 years 46.3% and older group 45.4%), ∼50% (50.7% and 50.7%) and ∼55% (56.4% and 58.0%) were best associated with glucose management indicators <7.0%, <6.8%, and <6.5%, respectively. TITRs of >45%, >50%, and >55% were achieved in 91%, 74%, and 55% of those age ≤15 years and 93%, 81%, and 57% of older group users, respectively, at optimal settings. CONCLUSIONS This study demonstrates that 1) mean TIR is high with a high mean TITR in MM780G users (>48%), 2) consistent use of optimal GT/AIT improves TITR (>56%), 3) the impact of these settings on TITR is larger than on TIR, and 4) a TITR target >50% is our suggested treatment goal.

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“…86 mmol/mol). Im Gegensatz hierzu erreichen bei der AID-Therapie die Patienten mit den höchsten Ausgangs-HbA 1c -Werten die größten Verbesserungen, sodass die Vorbedingung einer guten Stoffwechsellage mit der Studienlage der AID-Therapie als überholt gelten kann, und das weitgehend unabhängig vom Lebensalter [16,17].…”

Section: Paradigmenwechsel In Der Verordnung Von Insulinpumpenunclassified

Automatische Insulinabgabe-Systeme („AID-Systeme“)

Gehr,

Gölz

2024

Diabetologie und Stoffwechsel

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Seit Jahrzehnten wird daran geforscht, Alternativen zur lebenslangen Insulintherapie zu finden – bis heute ohne durchschlagenden Erfolg. Eine spürbare Entlastung der Menschen mit Diabetes mellitus Typ 1 ist auch mittelfristig eher durch moderne Diabetestechnologien zu erwarten, insbesondere durch die Kombination und Kopplung von rtCGM-Systemen (real time continuous Glucose Monitoring) und Insulinpumpen, basierend auf speziellen Algorithmen. Die AID-Therapie (automated Insulin Delivery) ist Gegenstand der vorliegenden Arbeit.

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A Meta-Analysis of Randomized Trial Outcomes for the t:slim X2 Insulin Pump with Control-IQ Technology in Youth and Adults from Age 2 to 72

Cited by 43 publications

References 17 publications

Efficacy of the hybrid closed-loop insulin delivery system in children and adolescents with type 1 diabetes: a meta-analysis with trial sequential analysis

Efficacy of the hybrid closed-loop insulin delivery system in children and adolescents with type 1 diabetes: a meta-analysis with trial sequential analysis

Time in Tight Glucose Range in Type 1 Diabetes: Predictive Factors and Achievable Targets in Real-World Users of the MiniMed 780G System

Automatische Insulinabgabe-Systeme („AID-Systeme“)

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