Objective To evaluate changes in glycated haemoglobin (HbA1c) following initiation of hybrid closed-loop (HCL) insulin pump therapy in children and young people (CYP) with previously elevated HbA1c in a real-world multicentre setting. Design Retrospective multicentre observational cohort study. Setting 13 National Health Service paediatric diabetes units within a regional diabetes network in England, UK. Patients CYP aged ≤19 years with type 1 diabetes of more than 1 year’s duration and HbA1c ≥69 mmol/mol at the time of HCL initiation and at least 3 months prior. Interventions Initiation of HCL insulin pump therapy. Main outcome measures Primary outcome was change in HbA1c following HCL initiation. Secondary outcomes included subgroup and pump system comparisons and changes in diabetes-related hospital admissions. Results A total of 220 participants were included. HbA1c decreased significantly following HCL initiation (p100 mmol/mol) and in participants transitioning from multiple daily injections. Outcomes were similar across HCL pump systems, and diabetes-related hospital admissions decreased overall following HCL initiation. Conclusions In this large, real-world cohort of CYP with high HbA1c, initiation of HCL therapy was associated with sustained improvements in glycaemic control and fewer diabetes-related hospital admissions, supporting its use in this high-risk population.
King et al. (Wed,) studied this question.