Glycemic Control in Physically Active Adolescents With T1D: Closed-Loop Control vs Remote Pump in Winter Sports

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Cold and altitude are additional challenges in glycemic control in teens with type 1 diabetes.
Cold and altitude are additional challenges in glycemic control in teens with type 1 diabetes.

HealthDay News — For adolescents with type 1 diabetes (T1D), a closed-loop control system is associated with improved glycemic control and reduced exposure to hypoglycemia during prolonged exercise, cold temperatures, and high altitude, according to a study published online in Diabetes Care.

Marc D. Breton, PhD, from the University of Virginia in Charlottesville, and colleagues conducted a randomized trial involving 32 adolescents with T1D who participated in a 5-day ski camp at 2 sites. Participants were randomized to the University of Virginia-closed-loop control system or remotely-monitored sensor-augmented pump.

The researchers found that the percentage time in range was improved using closed-loop control vs the physician-monitored open-loop (71.3% vs 64.7%; +6.6%; 95% CI, 1-12; P =.005), with maximum effect late at night. Overall, there was improvement in exposure to hypoglycemia and carbohydrate treatments (P =.001 and .007, respectively), with strong ski level effects during the daytime (P =.0001 and .006, respectively). Ski/snowboard proficiency was balanced between the groups, with a strong site effect. No adverse effects were seen in association with closed-loop control; feedback from participants was overwhelmingly positive.

"Closed-loop control in adolescents with T1D improved glycemic control and reduced exposure to hypoglycemia during prolonged intensive winter sport activities, despite the added challenges of cold and altitude," the authors write.

Disclosures: Several authors disclosed financial ties to the pharmaceutical industry.

Reference

Breton MD, Chernavvsky DR, Forlenza GP, et al. Closed loop control during intense prolonged outdoor exercise in adolescents with type 1 diabetes: the artificial pancreas ski study [published online August 2017]. Diabetes Care. doi:10.2337/dc17-0883

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