Effectiveness of a closed-loop control system and a virtual educational camp for children and adolescents with type 1 diabetes: a prospective multicenter real-life study

Aim: Education maximizes the benefits of new diabetes technology. Here we evaluated the impact of a virtual educational camp (vEC) on glucose control in children and adolescents with type 1 diabetes using a closed-loop control (CLC) system. Materials and methods: This was a prospective multicenter study of children and adolescents with type 1 diabetes using the Tandem Basal-IQ™ system. Insulin pumps were upgraded to Control-IQ™, and children and their parents participated in a three-day multidisciplinary vEC. Clinical data, glucose metrics, and HbA1c were evaluated over the 12 weeks prior to the Control-IQ update and over the 12 weeks after the vEC. Results: Forty-three children and adolescents (aged 7-16 years) with type 1 diabetes and their families participated in the vEC. The median percentage of time in target range (70-180 mg/dL; TIR) increased from 64% (interquartile range [IQR] 56-73) with Basal-IQ to 76% (IQR 71-81) with Control-IQ (p < 0.001). After the vEC, over 75% of participants achieved TIR >70%. The percentage of time between 180-250 mg/dL and above 250 mg/dL decreased by 5% (p < 0.01) and 6% (p < 0.01), respectively, while the time between 70-54 mg/dL and below 54 mg/dL remained low and unaltered. HbA1c decreased by 0.5% (p < 0.01). There were no diabetic ketoacidosis or severe hypoglycemia episodes. Conclusions: In this study of children managing their diabetes in the real-world setting, over 75% of children who participated in a vEC after starting a CLC system could obtain and maintain a TIR >70%. The vEC was feasible and resulted in a significant and persistent improvement in TIR in children and adolescents with type 1 diabetes.