Two Years with a Tubeless Automated Insulin Delivery System: A Single-Arm Multicenter Trial in Children, Adolescents, and Adults with Type 1 Diabetes

被引:5
|
作者
Criego, Amy B. [1 ]
Carlson, Anders L. [2 ]
Brown, Sue A. [3 ]
Forlenza, Gregory P. [4 ]
Bode, Bruce W. [5 ]
Levy, Carol J. [6 ]
Hansen, David W. [7 ]
Hirsch, Irl B. [8 ]
Bergenstal, Richard M. [2 ]
Sherr, Jennifer L. [9 ]
Mehta, Sanjeev N. [10 ]
Laffel, Lori M. [10 ]
Shah, Viral N. [4 ]
Bhargava, Anuj [11 ]
Weinstock, Ruth S. [12 ]
Macleish, Sarah A. [13 ]
Desalvo, Daniel J. [14 ]
Jones, Thomas C. [15 ]
Aleppo, Grazia [16 ]
Buckingham, Bruce A. [17 ]
Ly, Trang T. [18 ,19 ]
机构
[1] Int Diabet Ctr, Dept Pediat Endocrinol, Pk Nicollet, Minneapolis, MN USA
[2] Int Diabet Ctr, HealthPartners, Pk Nicollet, Minneapolis, MN USA
[3] Univ Virginia, Ctr Diabet Technol, Div Endocrinol, Charlottesville, VA USA
[4] Univ Colorado, Barbara Davis Ctr Diabet, Dept Pediat, Anschutz Med Campus, Aurora, CO USA
[5] Atlanta Diabet Associates, Atlanta, GA USA
[6] Icahn Sch Med Mt Sinai, Div Endocrinol Diabet & Metab, New York, NY USA
[7] SUNY Upstate Med Univ, Dept Pediat, Syracuse, NY USA
[8] Univ Washington, Dept Med, Seattle, WA USA
[9] Yale Sch Med, Dept Pediat, New Haven, CT USA
[10] Joslin Diabet Ctr, Harvard Med Sch, Boston, MA USA
[11] Iowa Diabet Res, W Des Moines, IA USA
[12] SUNY Upstate Med Univ, Dept Med, Syracuse, NY USA
[13] Univ Hosp Cleveland Med Ctr, Rainbow Babies & Childrens Hosp, Dept Pediat, Cleveland, OH USA
[14] Baylor Coll Med, Dept Pediat, Houston, TX USA
[15] Jones Ctr, East Coast Inst Res, Dept Res, Macon, GA USA
[16] Northwestern Univ, Feinberg Sch Med, Div Endocrinol Metab & Mol Med, Chicago, IL USA
[17] Stanford Univ, Dept Pediat, Div Pediat Endocrinol, Stanford, CA USA
[18] Insulet Corp, Acton, MA USA
[19] Insulet Corp, Clin Affairs, 100 Nagog Pk, Acton, MA 01720 USA
关键词
Type; 1; diabetes; Artificial pancreas; Insulin pumps; Clinical trials; Closed-loop systems;
D O I
10.1089/dia.2023.0364
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The Omnipod (R) 5 Automated Insulin Delivery (AID) System was shown to be safe and effective following 3 months of use in people with type 1 diabetes (T1D); however, data on the durability of these results are limited. This study evaluated the long-term safety and effectiveness of Omnipod 5 use in people with T1D during up to 2 years of use.Materials and Methods: After a 3-month single-arm, multicenter, pivotal trial in children (6-13.9 years) and adolescents/adults (14-70 years), participants could continue system use in an extension phase. HbA1c was measured every 3 months for up to 15 months; continuous glucose monitor metrics were collected for up to 2 years.Results: Participants (N = 224) completed median (interquartile range) 22.3 (21.7, 22.7) months of AID. HbA1c was reduced in the pivotal trial from 7.7% +/- 0.9% in children and 7.2% +/- 0.9% in adolescents/adults to 7.0% +/- 0.6% and 6.8% +/- 0.7%, respectively, (P < 0.0001), and was maintained at 7.2% +/- 0.7% and 6.9% +/- 0.6% after 15 months (P < 0.0001 from baseline). Time in target range (70-180 mg/dL) increased from 52.4% +/- 15.6% in children and 63.6% +/- 16.5% in adolescents/adults at baseline to 67.9% +/- 8.0% and 73.8% +/- 10.8%, respectively, during the pivotal trial (P < 0.0001) and was maintained at 65.9% +/- 8.9% and 72.9% +/- 11.3% during the extension (P < 0.0001 from baseline). One episode of diabetic ketoacidosis and seven episodes of severe hypoglycemia occurred during the extension. Children and adolescents/adults spent median 96.1% and 96.3% of time in Automated Mode, respectively.Conclusion: Our study supports that long-term use of the Omnipod 5 AID System can safely maintain improvements in glycemic outcomes for up to 2 years of use in people with T1D.Clinical Trials Registration Number: NCT04196140
引用
收藏
页码:11 / 23
页数:13
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