{"doi":"10.1089/dia.2023.0450","title":"Hybrid Closed Loop Systems Improve Glycemic Control and Quality of Life in Historically Minoritized Youth with Diabetes","abstract":"<jats:sec>\n                    <jats:title>Background:</jats:title>\n                    <jats:p>We assessed changes in glycemic control and person-reported outcome measures (PROMs) with t:slim X2 insulin pump with Control-IQ technology use among historically minoritized youth who are least likely to access hybrid closed loop (HCL) technology.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:</jats:title>\n                    <jats:p>\n                      This single-arm, prospective pilot study enrolled 15 publicly insured, insulin pump-naïve, non-Hispanic Black youth ages 6 to &lt;21 years with type 1 diabetes and hemoglobin A\n                      <jats:sub>1c</jats:sub>\n                      (HbA\n                      <jats:sub>1c</jats:sub>\n                      ) ≥10% in a 6-month study of HCL use. The primary outcome was absolute change in time in range (TIR) (70–180 mg/dL). Secondary outcomes included other continuous glucose monitor metrics, PROMs, and diabetic ketoacidosis (DKA) incidence.\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:</jats:title>\n                    <jats:p>\n                      For 13 youth (median 14.8 years, 53.3% female, HbA\n                      <jats:sub>1c</jats:sub>\n                      11.7%) who completed the study, baseline TIR of 12.3% (6.3–27.1%) increased 23.7%-points (16.9, 30.5%;\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       &lt; 0.001) or 5.7 h per day. Percent time &gt;250 mg/dL decreased 33.9%-points (−44.8, −23.1%;\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       &lt; 0.001) or 8.1 h per day from a baseline of 69.4% (51.6, 84.0%). Median time in HCL was 78.3% (59.7, 87.3%). Youth received 10.1 (9.2, 11.9) boluses per day, 71.7% (63.8, 79.3%) of which were HCL-initiated autoboluses. Diabetes-specific quality of life increased among parents (\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       &lt; 0.001) and youth (\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       = 0.004), and diabetes distress decreased in both groups (\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       &lt; 0.001,\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       = 0.005). Improvements in glycemia did not correlate with any baseline youth or parent PROMs. DKA was high at baseline (67 episodes/100-person years) and did not increase during the intervention (72 episodes/100-person years,\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       = 0.78).\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:</jats:title>\n                    <jats:p>Improvements in glycemic control and quality of life exceeding pivotal trial findings without increased safety risks among historically minoritized youth emphasize the need for equitable access to HCL systems.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>ClinicalTrials.gov:</jats:title>\n                    <jats:p>\n                      <jats:uri xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"http://clinicaltrials.gov\">clinicaltrials.gov</jats:uri>\n                      ID (NCT04807374).\n                    </jats:p>\n                  </jats:sec>","journal":"Diabetes Technology &amp; Therapeutics","year":2024,"id":609096,"datarank":0.47670807455219194,"base_score":3.1780538303479458,"endowment":3.1780538303479458,"self_citation_contribution":0.47670807455219194,"citation_network_contribution":0.0,"self_endowment_contribution":0.47670807455219194,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":23,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1133401,"name":"J Grundman","orcid":"0000-0002-0193-4193","position":1,"is_corresponding":false},{"id":1565212,"name":"Seema Meighan","orcid":null,"position":2,"is_corresponding":false},{"id":382521,"name":"Maureen Monaghan","orcid":"0000-0003-1350-7401","position":3,"is_corresponding":false},{"id":729670,"name":"Randi Streisand","orcid":"0000-0002-8535-8444","position":4,"is_corresponding":false},{"id":1133402,"name":"Amanda Perkins","orcid":"0000-0002-8532-691X","position":5,"is_corresponding":false},{"id":1133404,"name":"Brynn E. Marks","orcid":"0000-0002-4849-9774","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Hybrid Closed Loop Systems Improve Glycemic Control and Quality of Life in Historically Minoritized Youth with Diabetes","abstract":"<jats:sec>\n                    <jats:title>Background:</jats:title>\n                    <jats:p>We assessed changes in glycemic control and person-reported outcome measures (PROMs) with t:slim X2 insulin pump with Control-IQ technology use among historically minoritized youth who are least likely to access hybrid closed loop (HCL) technology.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:</jats:title>\n                    <jats:p>\n                      This single-arm, prospective pilot study enrolled 15 publicly insured, insulin pump-naïve, non-Hispanic Black youth ages 6 to &lt;21 years with type 1 diabetes and hemoglobin A\n                      <jats:sub>1c</jats:sub>\n                      (HbA\n                      <jats:sub>1c</jats:sub>\n                      ) ≥10% in a 6-month study of HCL use. The primary outcome was absolute change in time in range (TIR) (70–180 mg/dL). Secondary outcomes included other continuous glucose monitor metrics, PROMs, and diabetic ketoacidosis (DKA) incidence.\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:</jats:title>\n                    <jats:p>\n                      For 13 youth (median 14.8 years, 53.3% female, HbA\n                      <jats:sub>1c</jats:sub>\n                      11.7%) who completed the study, baseline TIR of 12.3% (6.3–27.1%) increased 23.7%-points (16.9, 30.5%;\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       &lt; 0.001) or 5.7 h per day. Percent time &gt;250 mg/dL decreased 33.9%-points (−44.8, −23.1%;\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       &lt; 0.001) or 8.1 h per day from a baseline of 69.4% (51.6, 84.0%). Median time in HCL was 78.3% (59.7, 87.3%). Youth received 10.1 (9.2, 11.9) boluses per day, 71.7% (63.8, 79.3%) of which were HCL-initiated autoboluses. Diabetes-specific quality of life increased among parents (\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       &lt; 0.001) and youth (\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       = 0.004), and diabetes distress decreased in both groups (\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       &lt; 0.001,\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       = 0.005). Improvements in glycemia did not correlate with any baseline youth or parent PROMs. DKA was high at baseline (67 episodes/100-person years) and did not increase during the intervention (72 episodes/100-person years,\n                      <jats:italic toggle=\"yes\">P</jats:italic>\n                       = 0.78).\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:</jats:title>\n                    <jats:p>Improvements in glycemic control and quality of life exceeding pivotal trial findings without increased safety risks among historically minoritized youth emphasize the need for equitable access to HCL systems.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>ClinicalTrials.gov:</jats:title>\n                    <jats:p>\n                      <jats:uri xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"http://clinicaltrials.gov\">clinicaltrials.gov</jats:uri>\n                      ID (NCT04807374).\n                    </jats:p>\n                  </jats:sec>","is_dataset_classified":null,"base_score":3.1780538303479458,"endowment":3.1780538303479458,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"38444316","pmcid":"PMC11071108","openalex_id":"https://openalex.org/W4392516497","authors":[],"funders":[{"funder_name":"NIDDK NIH HHS","grant_id":"K23 DK129827","title":null}],"total_grants":1,"fwci":6.1494,"citation_percentile":0.9722561,"influential_citations":0,"citation_trend":[{"year":2024,"count":5},{"year":2025,"count":12},{"year":2026,"count":6}],"oa_status":"green","license":"https://journals.sagepub.com/page/policies/text-and-data-mining-license","oa_locations":[{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11071108/pdf/dia.2023.0450.pdf","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11071108/pdf/dia.2023.0450.pdf","host_type":"repository"},{"url":"https://journals.sagepub.com/doi/full-xml/10.1089/dia.2023.0450","host_type":"publisher"},{"url":"https://journals.sagepub.com/doi/pdf/10.1089/dia.2023.0450","host_type":"publisher"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11071108","host_type":"repository"},{"url":"https://doi.org/10.1089/dia.2023.0450","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/38444316","host_type":"repository"}],"fields_of_study":["Diabetes Management and Research","Pancreatic function and diabetes","Diabetes and associated disorders"],"mesh_terms":["Glycemic Control","Adolescent","Child","Diabetes Mellitus","Female","Humans","Male","Pilot Projects","Prospective Studies","Quality of Life","Diabetic Ketoacidosis","Young Adult","Insulins"],"keywords":["Medicine","Glycemic","Diabetes mellitus","Diabetic ketoacidosis","Type 1 diabetes","Insulin pump","Internal medicine","Prospective cohort study","Distress","Quality of life (healthcare)","Insulin","Incidence (geometry)","Hemoglobin A","Endocrinology","Glycemic control","Psychological Outcomes","Pediatric Diabetes","Automated Insulin Delivery","Inequalities In Care"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"nct"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-07-31T03:10:51.936732Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}