837-P: Closed-Loop Insulin Delivery Improves Glycemic Control In Paediatric Patients with Type 1 Diabetes—A Systematic Review

Background: Type 1 Diabetes (T1D) in pediatric patients presents significant challenges in achieving optimal glycemic control. Closed-loop insulin delivery systems offer a modern approach to managing blood glucose levels by using continuous glucose monitoring data to adjust insulin delivery. This review aims to evaluate the impact of closed-loop insulin delivery on glycemic control in pediatric patients with T1D.

Methods: We searched PubMed, Scopus, Embase, and the WoS from their inception until June 2023 to identify relevant studies. We included studies focusing on closed-loop insulin delivery systems in children aged 0 to 18 with T1D. Our primary goal was to measure improved glycemic control by analyzing HbA1c changes.We extracted data and used established tools to assess the quality of the studies.

Results: 15 studies met the inclusion criteria, encompassing various closed-loop systems, including Continuous Subcutaneous Insulin Infusion (CSII), Dexcom G4, Florence D2, Omnipod 5, Medtronic Minimed, Minilink®REAL, Animas, and CamAPS FX. The studies demonstrated heterogeneous findings in glycemic control improvement, with significant reductions in HbA1c levels observed in most systems. Some variations were noted in outcomes, attributed to differences in study populations, system types, and study durations. A few studies reported adverse events such as diabetic ketoacidosis and sensor issues.

Conclusion: Closed-loop insulin delivery systems promise to enhance glycemic control in pediatric patients with T1D. While many studies reported favorable outcomes, further research is needed to understand system-specific effects, ensure safety, and address young patients' unique challenges. Standardizing outcome measures and conducting cost-effectiveness analyses are critical for broader adoption and successful integration into clinical practice.