Software updates of closed-loop systems may lead to improved coverage numbers in children with type 1 diabetes.

Time in range is one of the most effective ways to measure glycemic control in type 1 diabetes (T1D) patients. A closed-loop glucose control system has led to improvements in that metric. Some systems have reported up to a 9% increase in pediatric cases.

In a study published in JAMA network open,1 Researchers wanted to see if a software update would lead to even better times on the range.

T1D patients aged 6 to 17 years with carbohydrate counting utilizing a closed-loop system were invited to participate in the study (n=43; time since T1D diagnosis, range, 2-13 years). Participants were provided with an updated closed-loop system and data were shared through data synchronization software. At the beginning of the study, participants attended her three days of her Zoom sessions, performed exercise sessions led by her personal trainer, or watched information sessions. After this her three-day program, they updated the system’s software. The researchers looked at times ranging from one week before and after the update, to three weeks for him.

After the first week after the update, there was a significant increase in time in range compared to the previous system (median, 75% [IQR, 70%-82%] vs 64% [IQR, 54%-74%]; P.<.001), which remained stable at a median of 76% (IQR, 69%-82%) over the 3-week observation period. After 1 week, the time in range was median 11% longer after the update and 12% longer after 3 weeks. Neither diabetic ketoacidosis nor severe hypoglycemia was seen during the study period. Additionally, no increase in time under range was seen.


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