CoChat
Sign Up
Cited by 127Diabetes Management and ResearchDiabetes Treatment and ManagementDiabetes Management and Education

The DOI matches its Crossref record; 19 of the 21 references it cites were found in a registry or an index.

Hybrid closed-loop glucose control compared with sensor augmented pump therapy in older adults with type 1 diabetes: an open-label multicentre, multinational, randomised, crossover study

Open access
Boughton, Charlotte K, Hartnell, Sara, Thabit, Hood, Mubita, Womba M, Draxlbauer, Katharine, Poettler, Tina, Wilinska, Malgorzata E, Hood, Korey K, Mader, Julia K, Narendran, Parth, Leelarathna, Lalantha, Evans, Mark L, Hovorka, Roman·2022·The Lancet Healthy Longevity
DOI 10.1016/s2666-7568(22)00005-8PMC PMC8967297
Open this paper in CoChat — free account

Abstract

Background Older adults with type 1 diabetes have distinct characteristics that can make optimising glycaemic control challenging. We sought to test our hypothesis that hybrid closed-loop glucose control is safe and more effective than sensor-augmented pump (SAP) therapy in older adults with type 1 diabetes. Methods In an open-label, multicentre, multinational (UK and Austria), randomised, crossover study, adults aged 60 years and older with type 1 diabetes using insulin pump therapy underwent two 16-week periods comparing hybrid closed-loop (CamAPS FX, CamDiab, Cambridge, UK) and SAP therapy in random order. Block randomisation by means of central randomisation software to one of two treatment sequences was stratified by centre. The primary endpoint was the proportion of time sensor glucose was in target range between 3·9 and 10·0 mmol/L. Analysis for the primary endpoint and adverse events was by intention-to-treat. The study has completed and is registered at ClinicalTrials.gov NCT04025762. Findings 38 participants were enrolled. One participant withdrew during run-in because of difficulties with the study pump infusion sets. 37 participants (median [IQR] age 68 [63–70] years, mean [SD] baseline glycated haemoglobin [HbA 1c ]; 7·4% [0·9%]; 57 [10] mmol/mol) were randomly assigned between Sept 4, 2019, and Oct 2, 2020. The proportion of time with glucose between 3·9 and 10·0 mmol/L was significantly higher in the closed-loop group compared to the SAP group (79·9% [SD 7·9] vs 71·4% [13·2], difference 8·6 percentage points [95% CI 6·3 to 11·0]; p<0·0001). Two severe hypoglycaemia events occurred during the SAP period. There were two non-treatment related serious adverse events: cardiac arrest from pulmonary embolism associated with COVID-19 during the SAP period resulting in death, and a hospital presentation for parenteral hydrocortisone because of COVID-19 in a participant with adrenal insufficiency during the run-in period. Interpretation Hybrid closed-loop insulin delivery is safe and achieves superior glycaemic control to SAP therapy in older adults with long duration of type 1 diabetes. Importantly this was achieved without increasing the risk of hypoglycaemia in this population with risk factors for severe hypoglycaemia. This suggests that hybrid closed-loop therapy is a clinically important treatment option for older adults with type 1 diabetes. Funding National Institute of Diabetes and Digestive and Kidney Diseases.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/s2666-7568(22)00005-8

Cites

19 of 19 references verified0 citation errors · 0 not checkable

Statistics

Figures

Figure: Sensor glucose concentrations Median sensor glucose concentrations and IQRs during closed-loop insulin delivery (solid red line and red shaded area, n=36) and sensor-augmented pump therapy (dashed dark blue line and blue shaded area, n=37). Dashed horizontal lines indicate the target glucose range between 3·9 and 10 mmol/L.
Figure: Sensor glucose concentrations Median sensor glucose concentrations and IQRs during closed-loop insulin delivery (solid red line and red shaded area, n=36) and sensor-augmented pump therapy (dashed dark blue line and blue shaded area, n=37). Dashed horizontal lines indicate the target glucose range between 3·9 and 10 mmol/L.CC BY-NC-ND · PubMed Central

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Show all 21 references

Cited by

Sorted by citations

Related

See all

Metadata

Authors
Boughton, C. K., Hartnell, S., Thabit, H., Mubita, W. M., Draxlbauer, K., Poettler, T., Wilinska, M. E., Hood, K. K., Mader, J. K., Narendran, P., Leelarathna, L., Evans, M. L., & Hovorka, R.
Affiliations
  • Cambridge University Hospitals NHS Foundation Trust (GB)
  • Manchester Academic Health Science Centre (GB)
  • University Hospitals Birmingham NHS Foundation Trust (GB)
  • Medical University of Graz (AT)
  • Wellcome/MRC Institute of Metabolic Science (GB)
  • Stanford Medicine (US)
Corresponding author
Boughton, Charlotte K
ORCID
Venue
The Lancet Healthy Longevity
Publisher
Elsevier BV
Published
2022-03
Volume
3
Issue
3
Pages
e135-e142
ISSN
2666-7568 (ISSN-L)
DOI
10.1016/s2666-7568(22)00005-8
PMC
PMC8967297
OpenAlex
W4221125458
Cited by
127
References
21
Citations by year
2026: 25 · 2025: 37 · 2024: 29 · 2023: 25 · 2022: 11
FWCI
18.90
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Healthy Longevity (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion, cc-by-nc-nd)
  • Research Explorer (The University of Manchester) (submittedVersion)
  • Apollo (University of Cambridge) (submittedVersion, cc-by)
  • Apollo (University of Cambridge) (submittedVersion, cc-by-nc-nd)
  • Apollo (cc-by)
  • Apollo
Funders
  • National Institute for Health and Care Research
  • Eli Lilly and Company
  • Juvenile Diabetes Research Foundation United Kingdom
  • National Institute of Diabetes and Digestive and Kidney Diseases (1DP3DK112176-01)
  • Wellcome Trust
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords
hybrid closed-loop insulin delivery, sensor-augmented pump therapy, type 1 diabetes, older adults, glycemic control, time in range, hypoglycemia, insulin pump therapy, COVID-19 pandemic, adrenal insufficiency, HbA1c, adverse events, cortisol, pulmonary embolism
MeSH terms
COVID-19, Aged, Blood Glucose, Diabetes Mellitus, Type 1, Glucose, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Middle Aged, Treatment Outcome, Cross-Over Studies

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review