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2. Cambridge hybrid closed-loop algorithm in children and adolescents with type 1 diabetes: a multicentre 6-month randomised controlled trial

Author

Hovorka, R, Acerini, C L, Thankamony, A, Allen, J M, Boughton, C K, Dovc, K, Dunger, D B, Ware, J, Musolino, G, Tauschmann, M, Wilinska, M E, Hayes, J F, Hartnell, S, Slegtenhorst, S, Ruan, Y, Haydock, M, Mangat, J, Denvir, L, Kanthagnany, SK, Law, J, Randell, T, Sachdev, P, Saxton, M, Coupe, A, Stafford, S, Ball, A, Keeton, R, Cresswell, R, Crate, L, Cripps, H, Fazackerley, H, Looby, L, Navarra, H, Saddington, C, Smith, V, Verhoeven, V, Bratt, S, Khan, N, Moyes, L, Sandhu, K, West, C, Wadwa, R P, Alonso, G, Forlenza, G, Slover, R, Towers, L, Berget, C, Coakley, A, Escobar, E, Jost, E, Lange, S, Messer, L, Thivener, K, Campbell, F M, Yong, J, Metcalfe, E, Allen, M, Ambler, S, Waheed, S, Exall, J, Tulip, J, Buckingham, B A, Ekhlaspour, L, Maahs, D, Norlander, L, Jacobson, T, Twon, M, Weir, C, Leverenz, B, Keller, J, Davis, N, Kumaran, A, Trevelyan, N, Dewar, H, Price, G, Crouch, G, Ensom, R, Haskell, L, Lueddeke, LM, Mauras, N, Benson, M, Bird, K, Englert, K, Permuy, J, Ponthieux, K, Marrero-Hernandez, J, DiMeglio, L A, Ismail, H, Jolivette, H, Sanchez, J, Woerner, S, Kirchner, M, Mullen, M, Tebbe, M, Besser, R EJ, Basu, S, London, R, Makaya, T, Ryan, F, Megson, C, Bowen-Morris, J, Haest, J, Law, R, Stamford, I, Ghatak, A, Deakin, M, Phelan, K, Thornborough, K, Shakeshaft, J, Weinzimer, S A, Cengiz, E, Sherr, J L, Van Name, M, Weyman, K, Carria, L, Steffen, A, Zgorski, M, Sibayan, J, Beck, R W, Borgman, S, Davis, J, Rusnak, J, Hellman, A, Cheng, P, Kanapka, L, Kollman, C, McCarthy, C, Chalasani, S, Hood, K K, Hanes, S, Viana, J, Lanning, M, Fox, D S, Arreaza-Rubin, G, Eggerman, T, Green, N, Janicek, R, Gabrielson, D, Belle, S H, Castle, J, Green, J, Legault, L, Willi, S M, Wysham, C, Ware, Julia, Boughton, Charlotte K, Allen, Janet M, Wilinska, Malgorzata E, Tauschmann, Martin, Denvir, Louise, Thankamony, Ajay, Campbell, Fiona M, Wadwa, R Paul, Buckingham, Bruce A, Davis, Nikki, DiMeglio, Linda A, Mauras, Nelly, Besser, Rachel E J, Ghatak, Atrayee, Weinzimer, Stuart A, Hood, Korey K, Fox, D Steven, Kanapka, Lauren, Kollman, Craig, Sibayan, Judy, Beck, Roy W, and Hovorka, Roman

Published
2022
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3. The effect of closed-loop glucose control on C-peptide secretion in youth with newly diagnosed type 1 diabetes: the CLOuD RCT

Author

Boughton, Charlotte K, primary, Allen, Janet M, additional, Ware, Julia, additional, Wilinska, Malgorzata E, additional, Hartnell, Sara, additional, Thankamony, Ajay, additional, Randell, Tabitha, additional, Ghatak, Atrayee, additional, Besser, Rachel EJ, additional, Elleri, Daniela, additional, Trevelyan, Nicola, additional, Campbell, Fiona M, additional, Rankin, David, additional, Kimbell, Barbara, additional, Lawton, Julia, additional, Sibayan, Judy, additional, Calhoun, Peter, additional, Bailey, Ryan, additional, Dunseath, Gareth, additional, and Hovorka, Roman, additional

Published
2024
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4. Hypoglycemia and Hyperglycemia According to Type of Diabetes: Observations During Fully Closed-Loop Insulin Delivery in Adults With Type 1 and Type 2 Diabetes

Author

Kadiyala, Nithya, primary, Wilinska, Malgorzata E., additional, Daly, Aideen B., additional, Nwokolo, Munachiso, additional, Lakshman, Rama, additional, Hartnell, Sara, additional, Ware, Julia, additional, Allen, Janet M., additional, Cezar, Alina, additional, Evans, Mark L., additional, Hovorka, Roman, additional, and Boughton, Charlotte K., additional

Published
2024
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6. Cost-Effectiveness of Closed-Loop Automated Insulin Delivery Using the Cambridge Hybrid Algorithm in Children and Adolescents with Type 1 Diabetes: Results from a Multicenter 6-Month Randomized Trial

Author

Fox, D. Steven, primary, Ware, Julia, additional, Boughton, Charlotte K, additional, Allen, Janet M., additional, Wilinska, Malgorzata E, additional, Tauschmann, Martin, additional, Denvir, Louise, additional, Thankamony, Ajay, additional, Campbell, Fiona, additional, Wadwa, R. Paul, additional, Buckingham, Bruce A., additional, Davis, Nikki, additional, DiMeglio, Linda A., additional, Mauras, Nelly, additional, Besser, Rachel E. J., additional, Ghatak, Atrayee, additional, Weinzimer, Stuart A., additional, Kanapka, Lauren, additional, Kollman, Craig, additional, Sibayan, Judy, additional, Beck, Roy W., additional, Hood, Korey K., additional, and Hovorka, Roman, additional

Published
2024
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7. Effect of 48 Months of Closed-Loop Insulin Delivery on Residual C-Peptide Secretion and Glycemic Control in Newly Diagnosed Youth With Type 1 Diabetes: A Randomized Trial.

Author

Ware, Julia, Boughton, Charlotte K., Allen, Janet M., Wilinska, Malgorzata E., Hartnell, Sara, Thankamony, Ajay, Randell, Tabitha, Ghatak, Atrayee, Besser, Rachel E.J., Elleri, Daniela, Trevelyan, Nicola, Campbell, Fiona M., Sibayan, Judy, Bailey, Ryan, Calhoun, Peter, Dunseath, Gareth, Hovorka, Roman, Verhoeven, Vreni, Thankmonay, Ajay, and Acerini, Carlo

Subjects
TYPE 1 diabetes, GLYCEMIC control, HYPERGLYCEMIA, SECRETION, C-peptide, INSULIN, CANAGLIFLOZIN, INSULIN aspart
Abstract

OBJECTIVE: We evaluated the effect of long-term intensive metabolic control with hybrid closed-loop (CL) on residual C-peptide secretion and glucose control compared with standard insulin therapy in youth with type 1 diabetes over 48 months. RESEARCH DESIGN AND METHODS: Following the 24-month primary phase of a multicenter, randomized, parallel trial of 96 newly diagnosed youth aged 10 to 16.9 years, participants were invited to an extension phase using treatment allocated at randomization. They continued with hybrid CL using the Cambridge algorithm or standard insulin therapy (control) until 48 months after diagnosis. Analysis was by intention-to-treat. RESULTS: At 24 months after diagnosis, 81 participants (mean ± SD age 14 ± 2 years) continued in the extension phase (47 CL, 34 control). There was no difference in fasting C-peptide corrected for fasting glucose at 48 months between groups (CL: 5 ± 9 vs. control: 6 ± 14 pmol/L per mmol/L; mean adjusted difference −2 [95% CI −7, 4; P = 0.54]). Central laboratory HbA1c remained lower in the CL group by 0.9% (10 mmol/mol [95% CI 0.2, 1.5; 3, 17 mmol/mol); P = 0.009). Time in target range of 3.9 to 10.0 mmol/L was 12 percentage points (95% CI 3, 20; P = 0.008) higher in the CL group compared with control. There were 11 severe hypoglycemic events (6 CL, 5 control) and 7 diabetic ketoacidosis events (3 CL, 4 control) during the extension phase. CONCLUSIONS: Improved glycemic control was sustained over 48 months after diagnosis with CL insulin delivery compared with standard therapy in youth with type 1 diabetes. This did not appear to confer a protective effect on residual C-peptide secretion. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Safety of User-Initiated Intensification of Insulin Delivery Using Cambridge Hybrid Closed-Loop Algorithm.

Author

Ware, Julia, Wilinska, Malgorzata E., Ruan, Yue, Allen, Janet M., Boughton, Charlotte K., Hartnell, Sara, Bally, Lia, de Beaufort, Carine, Besser, Rachel E. J., Campbell, Fiona M., Draxlbauer, Katharine, Elleri, Daniela, Evans, Mark L., Fröhlich-Reiterer, Elke, Ghatak, Atrayee, Hofer, Sabine E., Kapellen, Thomas M., Leelarathna, Lalantha, Mader, Julia K., and Mubita, Womba M.

Published
2024
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10. CamAPS FX Hybrid Closed-Loop with Ultra-Rapid Lispro Compared with Standard Lispro in Adults with Type 1 Diabetes: A Double-Blind, Randomized, Crossover Study

Author

Nwokolo, Munachiso, primary, Lakshman, Rama, additional, Hartnell, Sara, additional, Alwan, Heba, additional, Ware, Julia, additional, Allen, Janet M., additional, Wilinska, Malgorzata E., additional, Evans, Mark L., additional, Hovorka, Roman, additional, and Boughton, Charlotte K., additional

Published
2023
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12. Fully closed-loop glucose control compared to insulin pump therapy with continuous glucose monitoring in adults with type 1 diabetes and sub-optimal glycemic control: a single-centre, randomized, crossover study

Author

K Boughton, Charlotte, primary, Hartnell, Sara, primary, Lakshman, Rama, primary, Nwokolo, Munachiso, primary, Wilinska, Malgorzata E, primary, Ware, Julia, primary, Allen, Janet M, primary, Evans, Mark L, primary, and Hovorka, Roman, primary

Published
2023
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13. Sleep Quality and Quantity in Caregivers of Children with Type 1 Diabetes Using Closed-Loop Insulin Delivery or a Sensor-Augmented Pump

Author

Madrid-Valero, Juan J., primary, Ware, Julia, additional, Allen, Janet M., additional, Boughton, Charlotte K., additional, Hartnell, Sara, additional, Wilinska, Malgorzata E., additional, Thankamony, Ajay, additional, de Beaufort, Carine, additional, Schierloh, Ulrike, additional, Campbell, Fiona M., additional, Sibayan, Judy, additional, Bocchino, Laura E., additional, Kollman, Craig, additional, Hovorka, Roman, additional, Gregory, Alice M., additional, and Consortium, KidsAP, additional

Published
2023
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16. Sleep Quality and Quantity in Caregivers of Children with Type 1 Diabetes Using Closed-Loop Insulin Delivery or a Sensor-Augmented Pump

Author

Madrid-Valero, Juan J., Ware, Julia, Allen, Janet M., Boughton, Charlotte K., Hartnell, Sara, Wilinska, Malgorzata E., Thankamony, Ajay, de Beaufort, Carine, Schierloh, Ulrike, Campbell, Fiona M., Sibayan, Judy, Bocchino, Laura E., Kollman, Craig, Hovorka, Roman, Gregory, Alice M., Consortium, KidsAP, Universidad de Alicante. Departamento de Psicología de la Salud, and Psicología Aplicada a la Salud y Comportamiento Humano (PSYBHE)

Subjects
Caregivers, Type 1 Diabetes, Sleep, Children
Abstract

Introduction. Parents of children living with type 1 diabetes (T1D) often report short and/or poor quality sleep. The development of closed-loop systems promises to transform the management of T1D. This study compared sleep quality and quantity in caregivers of children using a closed-loop system (CL) or sensor-augmented pump (SAP) therapy. Method. Data from sleep diaries, accelerometers, and questionnaires were provided by forty parents (classified as caregiver 1 (main analyses) or 2 (supplementary analyses) based on their contribution towards treatment management) of 21 very young children aged 1 to 7 years living with T1D (mean age: 4.7 (SD = 1.7)). Assessments were made at a single post-randomisation time point when the child was completing either the 16-week CL arm (n = 10) or the 16-week SAP arm (n = 11) of the main study. Results. Overall, there was a mixed pattern of results and group differences were not statistically significant at the p

Published
2023

17. Hybrid Closed-Loop with Faster Insulin Aspart Compared with Standard Insulin Aspart in Very Young Children with Type 1 Diabetes: A Double-Blind, Multicenter, Randomized, Crossover Study

Author

Ware, Julia, Allen, Janet M, Boughton, Charlotte K, Cezar, Alina, Hartnell, Sara, Wilinska, Malgorzata E, Thankamony, Ajay, Deakin, Mark, Leyland, Hannah, Phelan, Karen, Thornborough, Keith, Hovorka, Roman, Ware, Julia [0000-0002-4497-0979], Boughton, Charlotte K [0000-0003-3272-9544], and Apollo - University of Cambridge Repository

Subjects
Blood Glucose, Toddlers, Cross-Over Studies, Endocrinology, Diabetes and Metabolism, Aspart, Very young children, Artificial pancreas, Medical Laboratory Technology, Endocrinology, Type 1 diabetes, Diabetes Mellitus, Type 1, Double-Blind Method, Child, Preschool, Humans, Hypoglycemic Agents, Insulin, Closed-loop insulin delivery, Faster insulin aspart, Child, Insulin Aspart
Abstract

We evaluated the use of hybrid closed-loop (HCL) insulin delivery with faster insulin aspart (Fiasp) in very young children with type 1 diabetes (T1D). In a double-blind, multicenter, randomized, crossover study, children aged 2-6 years with T1D underwent two 8-week periods of HCL using CamAPS FX with Fiasp and standard insulin aspart (IAsp), in random order. Primary endpoint was between-treatment difference in time in target range 3.9-10.0 mmol/L. We randomized 25 participants: mean (±standard deviation) age 5.1 ± 1.3 years, baseline HbA1c 55 ± 9 mmol/mol. Time in range was not significantly different between interventions (64% ± 9% vs. 65% ± 9% for HCL with Fiasp vs. IAsp; mean difference -0.33% [95% confidence interval: -2.13 to 1.47; P = 0.71]). There was no significant difference in time with glucose

Published
2023

19. Time spent in hypoglycemia according to age and time-of-day: Observations during closed-loop insulin delivery

Author

Alwan, Heba, primary, Ware, Julia, additional, Boughton, Charlotte K, additional, Wilinska, Malgorzata, additional, Allen, Janet M, additional, Lakshman, Rama, additional, Nwokolo, Munachiso, additional, Hartnell, Sara, additional, Bally, Lia, additional, de Beaufort, Carine, additional, Besser, Rachel Elizabeth Jane, additional, Campbell, Fiona, additional, Davis, Nikki, additional, Denver, Louise, additional, Evants, Mark L, additional, Fröhlich-Reiterer, Elke, additional, Ghatak, Atrayee, additional, Hofer, Sabine E., additional, Kapellen, Thomas M, additional, Leelarathna, Lalantha, additional, Mader, Julia K, additional, Narendran, Parth, additional, Rami-Merhar, Birgit, additional, Tauschmann, Martin, additional, Thabit, Hood, additional, thankamony, Ajay, additional, and Hovorka, Roman, additional

Published
2023
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20. Hybrid closed-loop with faster insulin aspart compared with standard insulin aspart in very young children with type 1 diabetes: A double-blind, multicenter, randomized, crossover study

Author

Ware, Julia, primary, Allen, Janet M, additional, boughton, charlotte, additional, Cezar, Alina, additional, Hartnell, Sara, additional, Wilinska, Malgorzata, additional, Thankamony, Ajay, additional, Deakin, Mark, additional, Leyland, Hannah, additional, Phelan, Karen, additional, Thornborough, Keith, additional, and Hovorka, Roman, additional

Published
2023
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21. Sleep Quality and Quantity in Caregivers of Children with Type 1 Diabetes Using Closed-Loop Insulin Delivery or a Sensor-Augmented Pump

Author

Universidad de Alicante. Departamento de Psicología de la Salud, Madrid-Valero, Juan J., Ware, Julia, Allen, Janet M., Boughton, Charlotte K., Hartnell, Sara, Wilinska, Malgorzata E., Thankamony, Ajay, de Beaufort, Carine, Schierloh, Ulrike, Campbell, Fiona M., Sibayan, Judy, Bocchino, Laura E., Kollman, Craig, Hovorka, Roman, Gregory, Alice M., KidsAP Consortium, Universidad de Alicante. Departamento de Psicología de la Salud, Madrid-Valero, Juan J., Ware, Julia, Allen, Janet M., Boughton, Charlotte K., Hartnell, Sara, Wilinska, Malgorzata E., Thankamony, Ajay, de Beaufort, Carine, Schierloh, Ulrike, Campbell, Fiona M., Sibayan, Judy, Bocchino, Laura E., Kollman, Craig, Hovorka, Roman, Gregory, Alice M., and KidsAP Consortium

Abstract

Introduction. Parents of children living with type 1 diabetes (T1D) often report short and/or poor quality sleep. The development of closed-loop systems promises to transform the management of T1D. This study compared sleep quality and quantity in caregivers of children using a closed-loop system (CL) or sensor-augmented pump (SAP) therapy. Method. Data from sleep diaries, accelerometers, and questionnaires were provided by forty parents (classified as caregiver 1 (main analyses) or 2 (supplementary analyses) based on their contribution towards treatment management) of 21 very young children aged 1 to 7 years living with T1D (mean age: 4.7 (SD = 1.7)). Assessments were made at a single post-randomisation time point when the child was completing either the 16-week CL arm (n = 10) or the 16-week SAP arm (n = 11) of the main study. Results. Overall, there was a mixed pattern of results and group differences were not statistically significant at the level. However, when we consider the direction of results and results from caregiver 1, sleep diary data showed that parents of the CL (as compared to the SAP) group reported a shorter sleep duration but better sleep quality, fewer awakenings, and less wake after sleep onset (WASO). Actiwatch data showed that caregiver 1 of the CL (as compared to the SAP) group had a shorter sleep latency; greater sleep efficiency; and less wake after sleep onset. Results from the Pittsburgh Sleep Quality Index also showed better sleep quality for caregiver 1 of the CL group as compared to the SAP group. Conclusions. Results from this study suggest that sleep quality and quantity in parents of children using CL were not significantly different to those using SAP. Considering effect sizes and the direction of the non-significant results, CL treatment could be associated with better sleep quality in the primary caregiver. However, further research is needed to confirm these findings. This trial is registered with NCT05158816.

Published
2023

23. Fully Closed-Loop Glucose Control Compared With Insulin Pump Therapy With Continuous Glucose Monitoring in Adults With Type 1 Diabetes and Suboptimal Glycemic Control: A Single-Center, Randomized, Crossover Study.

Author

Boughton, Charlotte K., Hartnell, Sara, Lakshman, Rama, Nwokolo, Munachiso, Wilinska, Malgorzata E., Ware, Julia, Allen, Janet M., Evans, Mark L., and Hovorka, Roman

Abstract

OBJECTIVE: We evaluated the safety and efficacy of fully closed-loop with ultrarapid insulin lispro in adults with type 1 diabetes and suboptimal glycemic control compared with insulin pump therapy with continuous glucose monitoring (CGM). RESEARCH DESIGN AND METHODS: This single-center, randomized, crossover study enrolled 26 adults with type 1 diabetes using insulin pump therapy with suboptimal glycemic control (mean ± SD, age 41 ± 12 years, HbA1c 9.2 ± 1.1% [77 ± 12 mmol/mol]). Participants underwent two 8-week periods of unrestricted living to compare fully closed-loop with ultrarapid insulin lispro (CamAPS HX system) with insulin pump therapy with CGM in random order. RESULTS: In an intention-to-treat analysis, the proportion of time glucose was in range (primary end point 3.9–10.0 mmol/L) was higher during closed-loop than during pump with CGM (mean ± SD 50.0 ± 9.6% vs. 36.2 ± 12.2%, mean difference 13.2 percentage points [95% CI 9.5, 16.9], P < 0.001). Time with glucose >10.0 mmol/L and mean glucose were lower during closed-loop than during pump with CGM (mean ± SD time >10.0 mmol/L: 49.0 ± 9.9 vs. 62.9 ± 12.6%, mean difference −13.3 percentage points [95% CI −17.2, −9.5], P < 0.001; mean ± SD glucose 10.7 ± 1.1 vs. 12.0 ± 1.6 mmol/L, mean difference −1.2 mmol/L [95% CI −1.8, −0.7], P < 0.001). The proportion of time with glucose <3.9 mmol/L was similar between periods (median [interquartile range (IQR)] closed-loop 0.88% [0.51–1.55] vs. pump with CGM 0.64% [0.28–1.10], P = 0.102). Total daily insulin requirements did not differ (median [IQR] closed-loop 51.9 units/day [35.7–91.2] vs. pump with CGM 50.7 units/day [34.0–70.0], P = 0.704). No severe hypoglycemia or ketoacidosis occurred. CONCLUSIONS: Fully closed-loop insulin delivery with CamAPS HX improved glucose control compared with insulin pump therapy with CGM in adults with type 1 diabetes and suboptimal glycemic control. [ABSTRACT FROM AUTHOR]

Published
2023
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24. Evaluating the Impact of Applying Personal Glucose Targets in a Closed-Loop System for People With Type 1 Diabetes

Author

Fattah, Mustafa, primary, Boughton, Charlotte K., additional, Ware, Julia, additional, Allen, Janet M., additional, Hartnell, Sara, additional, Willinska, Malgorzata E., additional, Thankamony, Ajay, additional, de Beaufort, Carine, additional, Campbell, Fiona M., additional, Fröhlich-Reiterer, Elke, additional, Hofer, Sabine E., additional, Kapellen, Thomas M., additional, Rami-Merhar, Birgit, additional, Ghatak, Atrayee, additional, Randell, Tabitha L., additional, Besser, Rachel E. J., additional, Elleri, Daniela, additional, Trevelyan, Nicola, additional, Denvir MD, Louise, additional, Davis, Nikki, additional, Bally, Lia, additional, Thabit, Hood, additional, Leelarathna, Lalantha, additional, Evans, Mark L., additional, Mader, Julia K., additional, and Hovorka, Roman, additional

Published
2022
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25. Safety of User-Initiated Intensification of Insulin Delivery Using Cambridge Hybrid Closed-Loop Algorithm

Author

Ware, Julia, primary, Wilinska, Malgorzata E., additional, Ruan, Yue, additional, Allen, Janet M., additional, Boughton, Charlotte K., additional, Hartnell, Sara, additional, Bally, Lia, additional, de Beaufort, Carine, additional, Besser, Rachel E. J., additional, Campbell, Fiona M., additional, Draxlbauer, Katharine, additional, Elleri, Daniela, additional, Evans, Mark L., additional, Fröhlich-Reiterer, Elke, additional, Ghatak, Atrayee, additional, Hofer, Sabine E., additional, Kapellen, Thomas M., additional, Leelarathna, Lalantha, additional, Mader, Julia K., additional, Mubita, Womba M., additional, Narendran, Parth, additional, Poettler, Tina, additional, Rami-Merhar, Birgit, additional, Tauschmann, Martin, additional, Randell, Tabitha, additional, Thabit, Hood, additional, Thankamony, Ajay, additional, Trevelyan, Nicola, additional, and Hovorka, Roman, additional

Published
2022
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26. Time spent in hypoglycemia according to age and time-of-day: Observations during closed-loop insulin delivery

Author

Alwan, Heba, Ware, Julia, Boughton, Charlotte K, Wilinska, Malgorzata E, Allen, Janet M, Lakshman, Rama, Nwokolo, Munachiso, Hartnell, Sara, Bally, Lia, De Beaufort, Carine, Besser, Rachel EJ, Campbell, Fiona M, Davis, Nikki, Denvir, Louise, Evans, Mark L, Fröhlich-Reiterer, Elke, Ghatak, Atrayee, Hofer, Sabine E, Kapellen, Thomas M, Leelarathna, Lalantha, Mader, Julia K, Narendran, Parth, Rami-Mehrar, Birgit, Tauschmann, Martin, Thabit, Hood, Thankamony, Ajay, Hovorka, Roman, Alwan, Heba [0000-0001-5516-6022], Ware, Julia [0000-0002-4497-0979], Boughton, Charlotte K [0000-0003-3272-9544], Lakshman, Rama [0000-0002-4341-1307], Bally, Lia [0000-0003-1993-7672], Besser, Rachel EJ [0000-0002-4645-6324], Mader, Julia K [0000-0001-7854-4233], and Apollo - University of Cambridge Repository

Subjects
Adult, Blood Glucose, Adolescent, Endocrinology, Diabetes and Metabolism, Artificial pancreas, 610 Medicine & health, Young Adult, Insulin pump therapy, Endocrinology, Insulin Infusion Systems, 360 Social problems & social services, Insulin, Regular, Human, Humans, Insulin, Hypoglycemic Agents, Closed-loop insulin delivery, Child, Aged, Retrospective Studies, Cross-Over Studies, Middle Aged, Hypoglycemia, Medical Laboratory Technology, Type 1 diabetes, Diabetes Mellitus, Type 1, Treatment Outcome, Child, Preschool, Randomized trial
Abstract

Objective: We aimed to assess whether percentage of time spent in hypoglycemia during closed-loop insulin delivery differs by age group and time of day. Methods: We retrospectively analyzed data from hybrid closed-loop studies involving young children (2-7 years), children and adolescents (8-18 years), adults (19-59 years), and older adults (≥60 years) with type 1 diabetes. Main outcome was time spent in hypoglycemia

Published
2023
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27. Cambridge Hybrid Closed-Loop System in Very Young Children With Type 1 Diabetes Reduces Caregivers' Fear of Hypoglycemia and Improves Their Well-Being

Author

De Beaufort, Carine, Schierloh, Ulrike, Thankamony, Ajay, Ware, Julia, Wilinska, Malgorzata E, Fröhlich-Reiterer, Elke, Kapellen, Thomas M, Rami-Merhar, Birgit, Hofer, Sabine E, Campbell, Fiona M, Yong, James, Bocchino, Laura E, Sibayan, Judy, Lawton, Julia, Roze, Stephane, Fritsch, Maria, Thiele, Alena, Allen, Janet M, Boughton, Charlotte, Mader, Julia K, Kollman, Craig, Hovorka, Roman, Pit-Ten Cate, Ineke M, KidsAP Consortium, de Beaufort, Carine [0000-0003-4310-6799], and Apollo - University of Cambridge Repository

Subjects
KidsAP Consortium
Abstract

OBJECTIVE: To evaluate the impact of CamAPS FX hybrid closed-loop (HCL) automated insulin delivery in very young children with type 1 diabetes (T1D) on caregivers' well-being, fear of hypoglycemia, and sleepiness. RESEARCH DESIGN AND METHODS: We conducted a multinational, open-label, randomized crossover study. Children (age 1-7 years) with T1D received treatment for two 4-month periods in random order, comparing HCL with sensor augmented pump (control). At baseline and after each treatment period, caregivers were invited to complete World Health Organization-Five Well-Being Index, Hypoglycemia Fear Survey, and Epworth Sleepiness Scale questionnaires. RESULTS: Caregivers of 74 children (mean ± SD age 5 ± 2 years and baseline HbA1c 7.3 ± 0.7%; 42% female) participated. Results revealed significantly lower scores for hypoglycemia fear (P < 0.001) and higher scores for well-being (P < 0.001) after HCL treatment. A trend toward a reduction in sleepiness score was observed (P = 0.09). CONCLUSIONS: Our results suggest better well-being and less hypoglycemia fear in caregivers of very young children with T1D on CamAPS FX HCL.

Published
2022

28. Lived experience of CamAPS FX closed loop system in youth with type 1 diabetes and their parents

Author

Hood, Korey K, Garcia-Willingham, Natasha, Hanes, Sarah, Tanenbaum, Molly L, Ware, Julia, Boughton, Charlotte K, Allen, Janet M, Wilinska, Malgorzata E, Tauschmann, Martin, Denvir, Louise, Thankamony, Ajay, Campbell, Fiona, Wadwa, R Paul, Buckingham, Bruce A, Davis, Nikki, DiMeglio, Linda A, Mauras, Nelly, Besser, Rachel EJ, Ghatak, Atrayee, Weinzimer, Stuart A, Fox, D Steven, Kanapka, Lauren, Kollman, Craig, Sibayan, Judy, Beck, Roy W, Hovorka, Roman, DAN05 Consortium, Hood, Korey K [0000-0001-5730-7749], Boughton, Charlotte K [0000-0003-3272-9544], and Apollo - University of Cambridge Repository

Subjects
Blood Glucose, Parents, Diabetes Mellitus, Type 1, Treatment Outcome, Insulin Infusion Systems, Adolescent, Blood Glucose Self-Monitoring, Quality of Life, Humans, Insulin, Hypoglycemic Agents, Child
Abstract

AIM: To examine changes in the lived experience of type 1 diabetes after use of hybrid closed loop (CL), including the CamAPS FX CL system. MATERIALS AND METHODS: The primary study was conducted as an open-label, single-period, randomized, parallel design contrasting CL versus insulin pump (with or without continuous glucose monitoring). Participants were asked to complete patient-reported outcomes before starting CL and 3 and 6 months later. Surveys assessed diabetes distress, hypoglycaemia concerns and quality of life. Qualitative focus group data were collected at the completion of the study. RESULTS: In this sample of 98 youth (age range 6-18, mean age 12.7 ± 2.8 years) and their parents, CL use was not associated with psychosocial benefits overall. However, the subgroup (n = 12) using the CamAPS FX system showed modest improvements in quality of life and parent distress, reinforced by both survey (p < .05) and focus group responses. There were no negative effects of CL use reported by study participants. CONCLUSIONS: Closed loop use via the CamAPS FX system was associated with modest improvements in aspects of the lived experience of managing type 1 diabetes in youth and their families. Further refinements of the system may optimize the user experience.

Published
2022
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29. Cambridge hybrid closed-loop system in very young children with type 1 diabetes reduces caregivers’ fear of hypoglycemia and improves their well-being.

Author

de Beaufort, Carine, primary, Schierloh, Ulrike, primary, Thankamony, Ajay, primary, Ware, Julia, primary, Wilinska, Malgorzata E, primary, Fröhlich-Reiterer, Elke, primary, Kapellen, Thomas M., primary, Rami‐Merhar, Birgit, primary, Hofer, Sabine E., primary, M. Campbell, Fiona, primary, Yong, James, primary, Bocchino, Laura E., primary, Sibayan, Judy, primary, Lawton, Julia, primary, Roze, Stéphane, primary, Fritsch, Maria, primary, Thiele, Alena, primary, Allen, Janet M, primary, Boughton, Charlotte, primary, Mader, Julia K., primary, Kollman, Craig, primary, Hovorka, Roman, primary, Cate, Ineke M. Pit-ten, primary, and Consortium, KidsAP, primary

Published
2022
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30. Closed-Loop Therapy and Preservation of C-Peptide Secretion in Type 1 Diabetes

Author

Boughton, Charlotte K., primary, Allen, Janet M., additional, Ware, Julia, additional, Wilinska, Malgorzata E., additional, Hartnell, Sara, additional, Thankamony, Ajay, additional, Randell, Tabitha, additional, Ghatak, Atrayee, additional, Besser, Rachel E.J., additional, Elleri, Daniela, additional, Trevelyan, Nicola, additional, Campbell, Fiona M., additional, Sibayan, Judy, additional, Calhoun, Peter, additional, Bailey, Ryan, additional, Dunseath, Gareth, additional, and Hovorka, Roman, additional

Published
2022
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31. Home use of closed-loop insulin delivery for overnight glucose control in adults with type 1 diabetes: a 4-week, multicentre, randomised crossover study

Author

Thabit, Hood, Lubina-Solomon, Alexandra, Stadler, Marietta, Leelarathna, Lalantha, Walkinshaw, Emma, Pernet, Andrew, Allen, Janet M, Iqbal, Ahmed, Choudhary, Pratik, Kumareswaran, Kavita, Nodale, Marianna, Nisbet, Chloe, Wilinska, Malgorzata E, Barnard, Katharine D, Dunger, David B, Heller, Simon R, Amiel, Stephanie A, Evans, Mark L, and Hovorka, Roman

Published
2014
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32. 288-OR: Effect of 24 Months of Optimised Glucose Control on Residual C-Peptide Secretion in Youth with New Onset Type 1 Diabetes (T1D)

Author

BOUGHTON, CHARLOTTE K., primary, WARE, JULIA, additional, ALLEN, JANET M., additional, WILINSKA, MALGORZATA E., additional, HARTNELL, SARA, additional, THANKAMONY, AJAY, additional, RANDELL, TABITHA, additional, GHATAK, ATRAYEE, additional, BESSER, RACHEL, additional, ELLERI, DANIELA, additional, TREVELYAN, NICOLA, additional, CAMPBELL, FIONA, additional, SIBAYAN, JUDY, additional, BAILEY, RYAN, additional, CALHOUN, PETER, additional, DUNSEATH, GARETH J., additional, HOVORKA, ROMAN, additional, and CONSORTIUM, CLOUD, additional

Published
2022
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35. Cambridge hybrid closed-loop algorithm in children and adolescents with type 1 diabetes: a multicentre 6-month randomised controlled trial

Author

Ware, Julia, primary, Boughton, Charlotte K, additional, Allen, Janet M, additional, Wilinska, Malgorzata E, additional, Tauschmann, Martin, additional, Denvir, Louise, additional, Thankamony, Ajay, additional, Campbell, Fiona M, additional, Wadwa, R Paul, additional, Buckingham, Bruce A, additional, Davis, Nikki, additional, DiMeglio, Linda A, additional, Mauras, Nelly, additional, Besser, Rachel E J, additional, Ghatak, Atrayee, additional, Weinzimer, Stuart A, additional, Hood, Korey K, additional, Fox, D Steven, additional, Kanapka, Lauren, additional, Kollman, Craig, additional, Sibayan, Judy, additional, Beck, Roy W, additional, Hovorka, Roman, additional, Hovorka, R, additional, Acerini, C L, additional, Thankamony, A, additional, Allen, J M, additional, Boughton, C K, additional, Dovc, K, additional, Dunger, D B, additional, Ware, J, additional, Musolino, G, additional, Tauschmann, M, additional, Wilinska, M E, additional, Hayes, J F, additional, Hartnell, S, additional, Slegtenhorst, S, additional, Ruan, Y, additional, Haydock, M, additional, Mangat, J, additional, Denvir, L, additional, Kanthagnany, SK, additional, Law, J, additional, Randell, T, additional, Sachdev, P, additional, Saxton, M, additional, Coupe, A, additional, Stafford, S, additional, Ball, A, additional, Keeton, R, additional, Cresswell, R, additional, Crate, L, additional, Cripps, H, additional, Fazackerley, H, additional, Looby, L, additional, Navarra, H, additional, Saddington, C, additional, Smith, V, additional, Verhoeven, V, additional, Bratt, S, additional, Khan, N, additional, Moyes, L, additional, Sandhu, K, additional, West, C, additional, Wadwa, R P, additional, Alonso, G, additional, Forlenza, G, additional, Slover, R, additional, Towers, L, additional, Berget, C, additional, Coakley, A, additional, Escobar, E, additional, Jost, E, additional, Lange, S, additional, Messer, L, additional, Thivener, K, additional, Campbell, F M, additional, Yong, J, additional, Metcalfe, E, additional, Allen, M, additional, Ambler, S, additional, Waheed, S, additional, Exall, J, additional, Tulip, J, additional, Buckingham, B A, additional, Ekhlaspour, L, additional, Maahs, D, additional, Norlander, L, additional, Jacobson, T, additional, Twon, M, additional, Weir, C, additional, Leverenz, B, additional, Keller, J, additional, Davis, N, additional, Kumaran, A, additional, Trevelyan, N, additional, Dewar, H, additional, Price, G, additional, Crouch, G, additional, Ensom, R, additional, Haskell, L, additional, Lueddeke, LM, additional, Mauras, N, additional, Benson, M, additional, Bird, K, additional, Englert, K, additional, Permuy, J, additional, Ponthieux, K, additional, Marrero-Hernandez, J, additional, DiMeglio, L A, additional, Ismail, H, additional, Jolivette, H, additional, Sanchez, J, additional, Woerner, S, additional, Kirchner, M, additional, Mullen, M, additional, Tebbe, M, additional, Besser, R EJ, additional, Basu, S, additional, London, R, additional, Makaya, T, additional, Ryan, F, additional, Megson, C, additional, Bowen-Morris, J, additional, Haest, J, additional, Law, R, additional, Stamford, I, additional, Ghatak, A, additional, Deakin, M, additional, Phelan, K, additional, Thornborough, K, additional, Shakeshaft, J, additional, Weinzimer, S A, additional, Cengiz, E, additional, Sherr, J L, additional, Van Name, M, additional, Weyman, K, additional, Carria, L, additional, Steffen, A, additional, Zgorski, M, additional, Sibayan, J, additional, Beck, R W, additional, Borgman, S, additional, Davis, J, additional, Rusnak, J, additional, Hellman, A, additional, Cheng, P, additional, Kanapka, L, additional, Kollman, C, additional, McCarthy, C, additional, Chalasani, S, additional, Hood, K K, additional, Hanes, S, additional, Viana, J, additional, Lanning, M, additional, Fox, D S, additional, Arreaza-Rubin, G, additional, Eggerman, T, additional, Green, N, additional, Janicek, R, additional, Gabrielson, D, additional, Belle, S H, additional, Castle, J, additional, Green, J, additional, Legault, L, additional, Willi, S M, additional, and Wysham, C, additional

Published
2022
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37. A Randomized Closed-loop Trial in Very Young Children with Type 1 Diabetes

Author

Ware, Julia, Allen, Janet M, Boughton, Charlotte K, Wilinska, Malgorzata E, Hartnell, Sara, Thankamony, Ajay, Carine de Beaufort, Carine, Schierloh, Ulrike, Froehlich- Reiterer, Elke, Mader, Julia K, Kapellen, Thomas M, Rami-Merhar, Birgit, Tauschmann, Martin, Nagl, Katrin, Hofer, Sabine E, Campbell, Fiona, Yong, James, Hood, Korey, Lawton, Julia, Roze, Stephane, Sibayan, Judy, Bocchino, Laura, Kollman, Craig, and Hovorka, Roman

Abstract

BACKGROUND The possible advantage of hybrid closed-loop therapy (i.e., artificial pancreas) over sensor-augmented pump therapy in very young children with type 1 diabetes is unclear. METHODS In this multicenter, randomized, crossover trial, we recruited children 1 to 7 years of age with type 1 diabetes who were receiving insulin-pump therapy at seven centers across Austria, Germany, Luxembourg, and the United Kingdom. Participants received treatment in two 16-week periods, in random order, in which the closed-loop system was compared with sensor-augmented pump therapy (control). The primary end point was the between-treatment difference in the percentage of time that the sensor glucose measurement was in the target range (70 to 180 mg per deciliter) during each 16-week period. The analysis was conducted according to the intention-to-treat principle. Key secondary end points included the percentage of time spent in a hyperglycemic state (glucose level, >180 mg per deciliter), the glycated hemoglobin level, the mean sensor glucose level, and the percentage of time spent in a hypoglycemic state (glucose level

Published
2022
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39. Randomized Trial of Closed-Loop Control in Very Young Children with Type 1 Diabetes

Author

Ware, Julia, primary, Allen, Janet M., additional, Boughton, Charlotte K., additional, Wilinska, Malgorzata E., additional, Hartnell, Sara, additional, Thankamony, Ajay, additional, de Beaufort, Carine, additional, Schierloh, Ulrike, additional, Fröhlich-Reiterer, Elke, additional, Mader, Julia K., additional, Kapellen, Thomas M., additional, Rami-Merhar, Birgit, additional, Tauschmann, Martin, additional, Nagl, Katrin, additional, Hofer, Sabine E., additional, Campbell, Fiona M., additional, Yong, James, additional, Hood, Korey K., additional, Lawton, Julia, additional, Roze, Stephane, additional, Sibayan, Judy, additional, Bocchino, Laura E., additional, Kollman, Craig, additional, and Hovorka, Roman, additional

Published
2022
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41. Lived experience of CamAPS FX closed loop system in youth with type 1 diabetes and their parents.

Author

Hood, Korey K., Garcia‐Willingham, Natasha, Hanes, Sarah, Tanenbaum, Molly L., Ware, Julia, Boughton, Charlotte K., Allen, Janet M., Wilinska, Malgorzata E., Tauschmann, Martin, Denvir, Louise, Thankamony, Ajay, Campbell, Fiona, Wadwa, R. Paul, Buckingham, Bruce A., Davis, Nikki, DiMeglio, Linda A., Mauras, Nelly, Besser, Rachel E. J., Ghatak, Atrayee, and Weinzimer, Stuart A.

Subjects
TYPE 1 diabetes, PSYCHOLOGICAL distress, CLOSED loop systems, INSULIN pumps, QUALITY of life, HYPOGLYCEMIA
Abstract

Aim: To examine changes in the lived experience of type 1 diabetes after use of hybrid closed loop (CL), including the CamAPS FX CL system. Materials and Methods: The primary study was conducted as an open‐label, single‐period, randomized, parallel design contrasting CL versus insulin pump (with or without continuous glucose monitoring). Participants were asked to complete patient‐reported outcomes before starting CL and 3 and 6 months later. Surveys assessed diabetes distress, hypoglycaemia concerns and quality of life. Qualitative focus group data were collected at the completion of the study. Results: In this sample of 98 youth (age range 6‐18, mean age 12.7 ± 2.8 years) and their parents, CL use was not associated with psychosocial benefits overall. However, the subgroup (n = 12) using the CamAPS FX system showed modest improvements in quality of life and parent distress, reinforced by both survey (p <.05) and focus group responses. There were no negative effects of CL use reported by study participants. Conclusions: Closed loop use via the CamAPS FX system was associated with modest improvements in aspects of the lived experience of managing type 1 diabetes in youth and their families. Further refinements of the system may optimize the user experience. [ABSTRACT FROM AUTHOR]

Published
2022
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43. Psychological wellbeing of parents of very young children with type 1 diabetes – baseline assessment

Author

De Beaufort, Carine, Pit-Ten Cate, Ineke, Schierloh, Ulrike, Cohen, Nathan, Boughton, Charlotte, Tauschmann, Martin, Allen, Janet M., Nagl, Katrin, Fritsch, Maria, Yong, James, Metcalfe, Emily, Schaeffer, Dominique, Fichelle, Muriel, Thiele, Alena G., Abt, Daniela, Faninger, Kerstin, Mader, Julia K., Slegtenhorst, Sonja, Ashcroft, Nicole, Wilinska, Malgorzata E., Sibayan, Judy, Kollman, Craig, Hofer, Sabine E., Frohlich-Reiterer, Elke, Kapellen, Thomas, Acerini, Carlo, Campbell, Fiona, Rami-Merhar, Birgit, and Hovorka, Roman

Subjects
Very young children, Endocrinology, metabolism & nutrition [D06] [Human health sciences], Type 1 Diabetes, Hypoglycemia fear, child behavior, sleepiness, Parental well-being, Endocrinologie, métabolisme & nutrition [D06] [Sciences de la santé humaine]
Abstract

Background: Type 1 diabetes in young children is a heavy parental burden. As part of pilot phase of the KIDSAP01 study, we conducted a baseline assessment in parents to study the association between hypoglycemia fear, parental wellbeing and child behavior. Methods: All parents were invited to fill in baseline questionnaires: hypoglycemia fear survey (HFS), WHO-5, Epworth Sleepiness Scale and Strength and Difficulties Questionnaire (SDQ). Results: 24 children (median age: 5-year, range 1-7 years, 63% male, mean diabetes duration: 3 ± 1.7 years) participated. 23/24 parents filled out the questionnaires. We found a higher score for the hypoglycemia fear behavior 33.9 ± 5.6 compared to hypoglycemia worry 34.6 ± 12.2. Median WHO-5 score was 16 (8 - 22) with poor well-being in two parents. Median daytime sleepiness score was high in five parents (>10). For six children a high total behavioral difficulty score (>16) was reported. Pro social behavior score was lower than normal in six children (

Published
2021

44. User Engagement With the CamAPS FX Hybrid Closed-Loop App According to Age and User Characteristics

Author

Chen, Natalie S, Boughton, Charlotte K, Hartnell, Sara, Fuchs, Julia, Allen, Janet M, Willinska, Malgorzata E, Thankamony, Ajay, De Beaufort, Carine, Campbell, Fiona M, Fröhlich-Reiterer, Elke, Hofer, Sabine E, Kapellen, Thomas M, Rami-Merhar, Birgit, Ghatak, Atrayee, Randell, Tabitha L, Besser, Rachel EJ, Elleri, Daniela, Trevelyan, Nicola, Denvir, Louise, Davis, Nikki, Gurnell, Eleanor, Lindsay, Robert, Morris, Damian, Scott, Eleanor M, Bally, Lia, Thabit, Hood, Leelarathna, Lalantha, Evans, Mark L, Murphy, Helen R, Mader, Julia K, Hovorka, Roman, AiDAPT, AP@Home04, Boughton, Charlotte K [0000-0003-3272-9544], Campbell, Fiona M [0000-0002-7618-6759], Lindsay, Robert [0000-0002-9868-5217], Scott, Eleanor M [0000-0001-5395-8261], Bally, Lia [0000-0003-1993-7672], Mader, Julia K [0000-0001-7854-4233], Hovorka, Roman [0000-0003-2901-461X], and Apollo - University of Cambridge Repository

Subjects
Diabetes Mellitus, Type 1, Insulin Infusion Systems, Humans, Mobile Applications
Abstract

CamAPS FX (CamDiab, Cambridge, UK) is a hybrid closed-loop app hosting the Cambridge closed-loop algorithm on an Android smartphone, and is approved in the EU for use in children ≥1 year, and adults (including during pregnancy) with type 1 diabetes (T1D). The interoperable CamAPS FX app receives glucose data from a compatible CGM system (Dexcom G6; Dexcom, San Diego, CA), connects to a compatible insulin pump (Dana Diabecare RS and DANA-i; Sooil, Seoul, South Korea) to direct glucose-responsive insulin delivery every 8-12 minutes, includes a bolus calculator allowing discrete bolusing via the app, and streams data in real-time to cloud-based diabetes data repositories (Diasend/Glooko, Gothenburg, Sweden).

Published
2021

45. Home Use of an Artificial Beta Cell in Type 1 Diabetes

Author

Thabit, Hood, Tauschmann, Martin, Allen, Janet M., Leelarathna, Lalantha, Hartnell, Sara, Wilinska, Malgorzata E., Acerini, Carlo L., Dellweg, Sibylle, Benesch, Carsten, Heinemann, Lutz, Mader, Julia K., Holzer, Manuel, Kojzar, Harald, Exall, Jane, Yong, James, Pichierri, Jennifer, Barnard, Katharine D., Kollman, Craig, Cheng, Peiyao, Hindmarsh, Peter C., Campbell, Fiona M., Arnolds, Sabine, Pieber, Thomas R., Evans, Mark L., Dunger, David B., and Hovorka, Roman

Published
2015
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48. Parents' views about healthcare professionals having real‐time remote access to their young child's diabetes data: Qualitative study.

Author

Kimbell, Barbara, Rankin, David, Hart, Ruth I., Allen, Janet M., Boughton, Charlotte K., Campbell, Fiona, Fröhlich‐Reiterer, Elke, Hofer, Sabine E., Kapellen, Thomas M., Rami‐Merhar, Birgit, Schierloh, Ulrike, Thankamony, Ajay, Ware, Julia, Hovorka, Roman, and Lawton, Julia

Subjects
BLOOD sugar monitors, PARENT attitudes, REMOTE access networks, DATABASES, PSYCHOLOGY of parents, BLOOD sugar, PEDIATRICS, INTERVIEWING, TYPE 1 diabetes, RANDOMIZED controlled trials, COMPARATIVE studies, QUALITATIVE research, INSULIN pumps, DESCRIPTIVE statistics, MEDICAL referrals, STATISTICAL sampling, MEDICAL appointments, COVID-19 pandemic
Abstract

Objectives: We explored parents' views about healthcare professionals having remote access to their young child's insulin and glucose data during a clinical trial to inform use of data sharing in routine pediatric diabetes care. Research Design and Methods: Interviews with 33 parents of 30 children (aged 1–7 years) with type 1 diabetes participating in a randomized trial (KidsAP02) comparing hybrid closed‐loop system use with sensor‐augmented pump therapy. Data were analyzed using a qualitative descriptive approach. Results: Parents reported multiple benefits to healthcare professionals being able to remotely access their child's glucose and insulin data during the trial, despite some initial concerns regarding the insights offered into everyday family life. Key benefits included: less work uploading/sharing data; improved consultations; and, better clinical input and support from healthcare professionals between consultations. Parents noted how healthcare professionals' real‐time data access facilitated remote delivery of consultations during the COVID‐19 pandemic, and how these were more suitable for young children than face‐to‐face appointments. Parents endorsed use of real‐time data sharing in routine clinical care, subject to caveats regarding data access, security, and privacy. They also proposed that, if data sharing were used, consultations for closed‐loop system users in routine clinical care could be replaced with needs‐driven, ad‐hoc contact. Conclusions: Real‐time data sharing can offer clinical, logistical, and quality‐of‐life benefits and enhance opportunities for remote consultations, which may be more appropriate for young children. Wider rollout would require consideration of ethical and cybersecurity issues and, given the heightened intrusion on families' privacy, a non‐judgmental, collaborative approach by healthcare professionals. [ABSTRACT FROM AUTHOR]

Published
2022
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49. Psychological Well-Being of Parents of Very Young Children With Type 1 Diabetes – Baseline Assessment

Author

de Beaufort, Carine, primary, Pit-ten Cate, Ineke M., additional, Schierloh, Ulrike, additional, Cohen, Nathan, additional, Boughton, Charlotte K., additional, Tauschmann, Martin, additional, Allen, Janet M., additional, Nagl, Katrin, additional, Fritsch, Maria, additional, Yong, James, additional, Metcalfe, Emily, additional, Schaeffer, Dominique, additional, Fichelle, Muriel, additional, Thiele, Alena G., additional, Abt, Daniela, additional, Faninger, Kerstin, additional, Mader, Julia K., additional, Slegtenhorst, Sonja, additional, Ashcroft, Nicole, additional, Wilinska, Malgorzata E., additional, Sibayan, Judy, additional, Kollman, Craig, additional, Hofer, Sabine E., additional, Fröhlich-Reiterer, Elke, additional, Kapellen, Thomas M., additional, Acerini, Carlo L., additional, Campbell, Fiona, additional, Rami-Merhar, Birgit, additional, and Hovorka, Roman, additional

Published
2021
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50. Adolescents’ Experiences of Using a Smartphone Application Hosting a Closed-loop Algorithm to Manage Type 1 Diabetes in Everyday Life: Qualitative Study

Author

Rankin, David, primary, Kimbell, Barbara, additional, Allen, Janet M., additional, Besser, Rachel E. J., additional, Boughton, Charlotte K., additional, Campbell, Fiona, additional, Elleri, Daniela, additional, Fuchs, Julia, additional, Ghatak, Atrayee, additional, Randell, Tabitha, additional, Thankamony, Ajay, additional, Trevelyan, Nicola, additional, Wilinska, Malgorzata E., additional, Hovorka, Roman, additional, and Lawton, Julia, additional

Published
2021
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