Use of the t:slim X2 Control-IQ hybrid closed-loop system dramatically increased time-in-range (TiR) without increasing hypoglycaemia in a study of children and adolescents participating in high levels of exercise. TiR increased by almost 4 hours in a group of 12- and 17-year-olds participating in a 3-day skiing trip during which they spent about 5 hours on the ski slopes each day.
There was a significant difference in the increased TiR between the two age groups, according to Dr Boris Kovatchev who presented the study findings on day 2 of the EASD conference. On average, the children spent 30 minutes more TiR; whereas the adolescents spent a staggering 5.6 hours more per day within the 3.9–7.8 mmol/L (70–140 mg/dl) range. The reason for this difference is not completely understood but Dr Kovatchev speculated that the teenagers might have spent more time in closed loop.
After participating in the ski camp, 24 young people continued to use the Tandem closed-loop system for a further 3 days at home. During this time, their TiR improved from 53% to 71%, equating to an additional 4.4 hours in range. This improvement did not result in an increase in time spent in hypoglycaemia.
These findings reflect the results of the International Diabetes Closed Loop Protocol-3 study, in which TiR was 71% with Control-IQ technology compared to 59% in those using sensor-augmented pump therapy alone. Participants, who were aged at least 14 and had type 1 diabetes, also spent significantly less time in hypo- and hyperglycaemia and had statistically significant improvements in HbA1c and reductions in mean blood glucose.
Attempts to achieve remission, or at least a substantial improvement in glycaemic control, should be the initial focus at type 2 diabetes diagnosis.
9 May 2024