PDF(Pubmed)
Abstract：
The aim of this study was to assess the efficacy and safety of hybrid closed-loop (HCL) systems for insulin delivery in children and adolescents with type 1 diabetes (T1D). We searched Embase, PubMed, and Cochrane Library for randomized controlled trials (RCTs) published until March 2023 comparing the HCL therapy with control therapies for children and adolescents with T1D. We computed weighted mean differences (WMDs) for continuous outcomes and risk ratios (RRs) with 95% confidence intervals (CIs) for binary endpoints. Four RCTs and 501 patients were included, of whom 323 were randomized to HCL therapy. Compared with control therapies, HCL significantly improved the period during which glucose level was 70-180 mg/dL (WMD 10.89%, 95% CI 8.22-13.56%) and the number of participants with glycated hemoglobin (HbA1c) level < 7% (RR 2.61, 95% CI 1.29-5.28). Also, HCL significantly reduced the time during which glucoselevel was > 180 mg/dL (WMD-10.46%, 95% CI-13.99 to-6.93%) and the mean levels of glucose (WMD-16.67 mg/dL, 95% CI-22.25 to-11.09 mg/dL) and HbA1c (WMD-0.50%, 95% CI-0.68 to-0.31). There were no significant differences between therapies regarding time during which glucose level was < 70 mg/dL or <54 mg/dL or number of episodes of ketoacidosis, hyperglycemia, and hypoglycemia. In this meta-analysis, HCL compared with control therapies was associated with improved time in range and HbA1c control in children and adolescents with T1D and a similar profile of side effects. These findings support the efficacy of HCL in the treatment of T1D in this population.
摘要：
这项研究的目的是评估混合闭环（HCL）系统用于1型糖尿病（T1D）儿童和青少年胰岛素输送的有效性和安全性。我们搜查了Embase,PubMed,和CochraneLibrary在2023年3月之前发表的随机对照试验（RCT）中，比较了HCL治疗与对照治疗的儿童和青少年T1D。我们计算了连续结果的加权平均差（WMD）和二元终点的风险比（RR）和95％置信区间（CI）。纳入4例RCT和501例患者，其中323人随机接受HCL治疗。与对照疗法相比，HCL显着改善了葡萄糖水平为70-180mg/dL的时期（WMD10.89％，95％CI8.22-13.56％）和糖化血红蛋白（HbA1c）水平<7％的参与者人数（RR2.61，95％CI1.29-5.28）。此外，HCL显着降低了葡萄糖浓度>180mg/dL的时间（WMD-10.46％，95%CI-13.99至-6.93%）和葡萄糖的平均水平（WMD-16.67mg/dL，95%CI-22.25至-11.09mg/dL）和HbA1c（WMD-0.50%，95%CI-0.68至-0.31）。关于血糖水平<70mg/dL或<54mg/dL的时间或酮症酸中毒的发作次数，治疗之间没有显着差异。高血糖症,和低血糖。在这个荟萃分析中，与对照治疗相比，HCL与T1D儿童和青少年的范围和HbA1c控制时间改善相关，副作用相似。这些发现支持HCL在该人群中治疗T1D的功效。
