Improving Glycemic Markers in Children with Type 1 Diabetes Using Technology

Time in range is 1 of the most effective ways to measure glycemic control in patients who have type 1 diabetes (T1D). Closed-loop glucose control systems have led to improvement of that metric, with some systems reporting an increase of up to 9% in pediatric cases—a significant increase as this population may struggle with hitting glycemic control targets.

In a study published in JAMA Network Open,¹ researchers examined whether a software update led to even better time within range.

Patients aged 6 to 17 with T1D who utilized a closed-loop system with carbohydrate counting were invited to participate in the research (n=43; time since T1D diagnosis, range, 2-13 years). Participants were given an updated closed-loop system, and shared data through data-syncing software. At the start of the study, participants attended Zoom sessions for 3 days, either doing exercise sessions led by personal trainers or watching information sessions. Following this 3-day program, they updated the software on their system. Researchers looked at the time in range 1 week and 3 weeks before and after the updates.

Following the update, there was a significant increase in time in range compared with the previous system after the first week (median, 75% [IQR, 70%-82%] vs 64% [IQR, 54%-74%]; P <.001), and remained steady for the entire 3-week observation period at a median of 76% (IQR, 69%-82%). After 1 week, time in range was a median 11% higher after the update and 12% higher after 3 weeks. Neither severe hypoglycemia not diabetic ketoacidosis were seen during the study period. Furthermore, no increase in time below range was seen.