Hybrid closed-loop insulin delivery does not affect rate of severe hypoglycemia and increases rate of ketoacidosis
By Elana Gotkine HealthDay Reporter
FRIDAY, Feb. 28, 2025 (HealthDay News) — For young people with type 1 diabetes, hybrid closed-loop insulin delivery does not affect the rate of severe hypoglycemia and is associated with an increased risk for diabetic ketoacidosis, but it is also associated with a lower risk for hypoglycemic coma, according to a study published online in the February issue of The Lancet Diabetes & Endocrinology.
Beate Karges, M.D., from RWTH Aachen University in Germany, and colleagues conducted a population-based cohort study involving young people with type 1 diabetes participating in the Diabetes Prospective Follow-up initiative. Participants were aged 2 to 20 years, with a diabetes duration of more than one year. The analysis included 13,922 young people: 7,088 used closed-loop therapy and 6,834 used open-loop therapy.
The researchers found that the rate of ketoacidosis was higher for those using closed- versus open-loop therapy (1.74 versus 0.96 per 100 patient-years; incidence rate ratio, 1.81), while there was no significant between-group difference in the rate of severe hypoglycemia. The rate of hypoglycemic coma was significantly lower for individuals using closed- versus open-loop therapy (0.62 versus 0.91 per 100 patient-years; incidence rate ratio, 0.68). Compared with those in the open-loop therapy group, patients in the closed-loop therapy group had a lower hemoglobin A1c level, higher percentage of time in target glucose range of 3.9 to 10.0 mmol/L, and less glycemic variability. For those with an HbA1c of 8.5 percent or higher, the rate of ketoacidosis was particularly high in the closed-loop versus open-loop therapy group.
“The findings of this study could have clinical implications for the care of young people with type 1 diabetes,” the authors write.
Several authors disclosed ties to the pharmaceutical and medical technology industries.
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