Background: The Medtronic 670G Hybrid Closed Loop (HCL) is completing pivotal trials in children with type 1 diabetes <7 years old. Little is known about how to support families and young children using HCL.

Methods: Participants ages 2-7 in the 670G pivotal trial extension phase participated in novel, ongoing, multicenter videoconferencing interventions to support HCL use. Families downloaded HCL every 2 weeks and were randomized to two support interventions or a minimum feedback (control arm) targeted to either failed adherence (<80% Auto Mode) or suboptimal glycemic control (time 70-180 mg/dl <70%) by Sequential Multiple Assignment Randomization Trial (SMART) design. Interventions included two audio/videoconferencing sessions in a 2-week period. Participants were evaluated and re-randomized every 2 weeks over 3 months. Paired t-tests were used to compare glycemic and quality-of-life outcomes.

Results: Child-parent dyads (n=23) were enrolled (mean child age 5.2 ± 1.5 years, 39% female, mean diabetes duration 34 months). Dyads received a total of 39 interventions. HbA1c, Time-in-Range, and Auto Mode use remained stable over 3 months, and diabetes distress and hypoglycemia fear and confidence improved significantly (Table). Data collection is ongoing.

Conclusion: Targeted interventions for caregivers of young children using HCL demonstrated quality-of-life improvements without deterioration in glycemic control or Auto Mode use.

Disclosure

L.H. Messer: Advisory Panel; Self; Capillary Biomedical, Inc. Consultant; Self; Clinical Sensors. S. Hanes: None. I. Tabatabai: None. L. DiMeglio: Research Support; Self; Amgen Inc., Caladrius Biosciences, Inc., Janssen Research & Development, Medtronic, Sanofi. Other Relationship; Self; Dexcom, Inc. T.S. Hannon: Advisory Panel; Self; Eli Lilly and Company. G.P. Forlenza: Advisory Panel; Self; Dexcom, Inc. Consultant; Self; Medtronic MiniMed, Inc., Tandem Diabetes Care. Research Support; Self; Dexcom, Inc., Insulet Corporation, Medtronic MiniMed, Inc., Tandem Diabetes Care. S. Woerner: None. S. Lange: Other Relationship; Self; Medtronic MiniMed, Inc. K.A. Driscoll: None. K.K. Hood: Consultant; Self; Lilly Diabetes. Research Support; Self; Dexcom, Inc. Speaker's Bureau; Self; Johnson & Johnson Diabetes Institute. H. Rodriguez: Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Daiichi Pharm Corp, MannKind Corporation, Medtronic MiniMed, Inc. Research Support; Spouse/Partner; Medtronic MiniMed, Inc. Research Support; Self; Takeda Pharmaceutical Company Limited. Other Relationship; Self; Merck & Co., Inc., Novartis Pharmaceuticals Corporation, Novo Nordisk Inc. B.A. Buckingham: Advisory Panel; Self; ConvaTec Inc., Novo Nordisk Inc., Profusa, Inc. Consultant; Self; Medtronic MiniMed, Inc. Research Support; Self; Beta Bionics, ConvaTec Inc., Dexcom, Inc., Insulet Corporation, Medtronic MiniMed, Inc., Tandem Diabetes Care. Other Relationship; Self; Insulet Corporation, Tandem Diabetes Care.

Funding

National Institute of Diabetes and Digestive and Kidney Diseases

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.