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Efficacy of the hybrid closed-loop insulin delivery system in children and adolescents with type 1 diabetes: a meta-analysis with trial sequential analysis

Efficacy of the hybrid closed-loop insulin delivery system in children and adolescents with type 1 diabetes: a meta-analysis with trial sequential analysis

Authors :
Rafael Oliva Morgado Ferreira
Talita Trevisan
Eric Pasqualotto
Pedro Schmidt
Matheus Pedrotti Chavez
Janine Midori Figueiredo Watanabe
Simone van de Sande-Lee
Source :
Archives of Endocrinology and Metabolism, Vol 68 (2024)
Publication Year :
2024
Publisher :
Brazilian Society of Endocrinology and Metabolism, 2024.

Abstract

ABSTRACT The aim of this study was to assess the efficacy and safety of hybrid closed-loop (HCL) systems for insulin delivery in children and adolescents with type 1 diabetes (T1D). We searched Embase, PubMed, and Cochrane Library for randomized controlled trials (RCTs) published until March 2023 comparing the HCL therapy with control therapies for children and adolescents with T1D. We computed weighted mean differences (WMDs) for continuous outcomes and risk ratios (RRs) with 95% confidence intervals (CIs) for binary endpoints. Four RCTs and 501 patients were included, of whom 323 were randomized to HCL therapy. Compared with control therapies, HCL significantly improved the period during which glucose level was 70-180 mg/dL (WMD 10.89%, 95% CI 8.22-13.56%) and the number of participants with glycated hemoglobin (HbA1c) level < 7% (RR 2.61, 95% CI 1.29-5.28). Also, HCL significantly reduced the time during which glucose level was > 180 mg/dL (WMD -10.46%, 95% CI -13.99 to -6.93%) and the mean levels of glucose (WMD -16.67 mg/dL, 95% CI -22.25 to -11.09 mg/dL) and HbA1c (WMD -0.50%, 95% CI -0.68 to -0.31). There were no significant differences between therapies regarding time during which glucose level was < 70 mg/dL or

Details

Language :
English
ISSN :
23594292
Volume :
68
Database :
Directory of Open Access Journals
Journal :
Archives of Endocrinology and Metabolism
Publication Type :
Academic Journal
Accession number :
edsdoj.4970cb47d815428aa18ab43c0d6b7d0b
Document Type :
article
Full Text :
https://doi.org/10.20945/2359-4292-2023-0280