{
  "abstract": "Objective To evaluate changes in glycated haemoglobin (HbA1c) following initiation of hybrid closed-loop (HCL) insulin pump therapy in children and young people (CYP) with previously elevated HbA1c in a real-world multicentre setting.Design Retrospective multicentre observational cohort study.Setting 13 National Health Service paediatric diabetes units within a regional diabetes network in England, UK.Patients CYP aged ≤19 years with type 1 diabetes of more than 1 year’s duration and HbA1c ≥69 mmol/mol at the time of HCL initiation and at least 3 months prior.Interventions Initiation of HCL insulin pump therapy.Main outcome measures Primary outcome was change in HbA1c following HCL initiation. Secondary outcomes included subgroup and pump system comparisons and changes in diabetes-related hospital admissions.Results A total of 220 participants were included. HbA1c decreased significantly following HCL initiation (p<0.001), falling from a mean of 82.5 mmol/mol at baseline to 72.8 mmol/mol within the first 3 months and remaining stable thereafter with a mean value of 69.3 mmol/mol at 12 months. Improvements were observed across all subgroups, with the greatest reductions in those with very high baseline HbA1c (>100 mmol/mol) and in participants transitioning from multiple daily injections. Outcomes were similar across HCL pump systems, and diabetes-related hospital admissions decreased overall following HCL initiation.Conclusions In this large, real-world cohort of CYP with high HbA1c, initiation of HCL therapy was associated with sustained improvements in glycaemic control and fewer diabetes-related hospital admissions, supporting its use in this high-risk population.",
  "authors": [
    {
      "affiliations": [
        "Department of Paediatrics, St George’s University Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "Anna Caitlin King"
    },
    {
      "affiliations": [
        "Department of Paediatrics, East Kent Hospitals University NHS Foundation Trust, Ashford, UK"
      ],
      "name": "Peter Christian"
    },
    {
      "affiliations": [
        "Statsconsultancy, Amersham, UK"
      ],
      "name": "Paul Bassett"
    },
    {
      "affiliations": [
        "Department of Paediatrics, Croydon University Hospital, London, UK"
      ],
      "name": "Edward Holloway"
    }
  ],
  "title": "Real-world outcomes of hybrid closed-loop insulin pump therapy in UK children and young people with type 1 diabetes and high HbA1c: a multicentre retrospective cohort study",
  "uid": "1fae3f38-2881-5a45-9999-4b878b6536f5"
}