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Safety and Efficacy of Initializing the Control-IQ Artificial Pancreas System Based on Total Daily Insulin in Adolescents with Type 1 Diabetes

2020; Mary Ann Liebert, Inc.; Volume: 22; Issue: 8 Linguagem: Inglês

10.1089/dia.2019.0471

1557-8593

Melissa J. Schoelwer, J. Robic, Thibault Gautier, Chiara Fabris, Kelly Carr, Mary Clancy-Oliveri, Sue A. Brown, Stacey M. Anderson, Mark D. DeBoer, Daniel R. Cherñavvsky, Marc D. Breton,

Diabetes and associated disorders

Objective: To assess the safety and efficacy of a simplified initialization for the Tandem t:slim X2 Control-IQ hybrid closed-loop system, using parameters based on total daily insulin ("MyTDI") in adolescents with type 1 diabetes under usual activity and during periods of increased exercise. Research Design and Methods: Adolescents with type 1 diabetes 12–18 years of age used Control-IQ for 5 days at home using their usual parameters. Upon arrival at a 60-h ski camp, participants were randomized to either continue Control-IQ using their home settings or to reinitialize Control-IQ with MyTDI parameters. Control-IQ use continued for 5 days following camp. The effect of MyTDI on continuous glucose monitoring outcomes were analyzed using repeated measures analysis of variance (ANOVA): baseline, camp, and at home. Results: Twenty participants were enrolled and completed the study; two participants were excluded from the analysis due to absence from ski camp (1) and illness (1). Time in range was similar between both groups at home and camp. A tendency to higher time 40% tended to show greater time in the euglycemic range improvements between baseline and home than users with ratios <40% (+16.3% vs. −9.0%, P = 0.012). All participants maintained an average of 95% time in closed loop (84.1%–100%). Conclusions: MyTDI is a safe, effective, and easy way to determine insulin parameters for use in the Control-IQ artificial pancreas. Future modifications to account for the influence of carbohydrate intake on MyTDI calculations might further improve time in range.