Charlotte K. Boughton, Ph.D., from the Wolfson Diabetes and Endocrine Clinic at the University of Cambridge in the United Kingdom, and colleagues conducted a randomized trial involving youth aged 10.0 to 16.9 years within 21 days of type 1 diabetes diagnosis. Ninety-seven participants were randomly assigned to receive 24 months of hybrid closed-loop therapy or standard insulin therapy (51 and 46 participants, respectively). The area under the curve (AUC) for the plasma C-peptide level (after a mixed-meal tolerance test) at 12 months after diagnosis was assessed as the primary end point.
The researchers observed no significant difference between the groups in the AUC for the C-peptide level at 12 months (geometric mean, 0.35 and 0.46 pmol/mL with closed-loop and control therapy, respectively). At 24 months, there was also no substantial difference in the AUC for the C-peptide level (geometric mean, 0.18 and 0.24 pmol/mL, respectively). The arithmetic mean glycated hemoglobin level was 4 and 11 mmol per mole lower in the closed-loop versus the control group at 12 and 24 months, respectively.
“A sustained period of hybrid closed-loop glucose control after diagnosis of type 1 diabetes in children and adolescents did not appear to prevent the decline in residual C-peptide secretion,” the authors write.