Patient-Reported Outcomes in a Randomized Trial of Closed-Loop Control: The Pivotal International Diabetes Closed-Loop Trial

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Kudva, Yogish | Laffel, Lori | Brown, Sue | Raghinaru, Dan | Pinsker, Jordan | Ekhlaspour, Laya | Levy, Carol | Messer, Laurel | Kovatchev, Boris | Lum, John | Beck, Roy | Gonder-Frederick, Linda | Anderson, Stacey | Emory, Emma | Voelmle, Mary | Conshafter, Katie | Morris, Kim | Oliveri, Mary | Mitchell, Harry | Calvo, Kayla | Wakeman, Christian | Breton, Marc | Isganaitis, Elvira | Ambler-Osborn, Louise | Flint, Emily | Kim, Kenny | Roethke, Lindsay | Church, Mei | Andre, Camille | Piper, Molly | Lam, David | O'Malley, Grenye | Levister, Camilla | Ogyaadu, Selassie | Lovett, Jessica | Simha, Vinaya | Dadlani, Vikash | Mccrady-Spitzer, Shelly | Reid, Corey | Kumari, Kanchan | Wadwa, R. Paul | Forlenza, Greg | Alonso, G. Todd | Slover, Robert | Jost, Emily | Berget, Cari | Towers, Lindsey | Rossick-Solis, Alex | Buckingham, Bruce | Jacobson, Tali | Town, Marissa | Tabatabai, Ideen | Keller, Jordan | Salas, Evalina | Doyle, Francis | Dassau, Eyal | Passman, Samantha | Campos, Tiffany | Kollman, Craig | Murphy, Carlos | Patibandla, Nandan | Borgman, Sarah | Arreaza-Rubín, Guillermo | Green, Neal | Renard, Eric | Cobelli, Claudio | Reznik, Yves | Janicek, Robert | Gabrielson, Deanna | Belle, Steven | Castle, Jessica | Green, Jennifer | Legault, Laurent | Willi, Steven | Wysham, Carol | Eggerman, Thomas

Edité par CCSD ; Mary Ann Liebert -

International audience. Background: Closed-loop control (CLC) has been shown to improve glucose time in range and other glucose metrics; however, randomized trials >3 months comparing CLC with sensor-augmented pump (SAP) therapy are limited. We recently reported glucose control outcomes from the 6-month international Diabetes Closed-Loop (iDCL) trial; we now report patient-reported outcomes (PROs) in this iDCL trial. Methods: Participants were randomized 2:1 to CLC (N = 112) versus SAP (N = 56) and completed questionnaires, including Hypoglycemia Fear Survey, Diabetes Distress Scale (DDS), Hypoglycemia Awareness, Hypoglycemia Confidence, Hyperglycemia Avoidance, and Positive Expectancies of CLC (INSPIRE) at baseline, 3, and 6 months. CLC participants also completed Diabetes Technology Expectations and Acceptance and System Usability Scale (SUS). Results: The Hypoglycemia Fear Survey Behavior subscale improved significantly after 6 months of CLC compared with SAP. DDS did not differ except for powerless subscale scores, which worsened at 3 months in SAP. Whereas Hypoglycemia Awareness and Hyperglycemia Avoidance did not differ between groups, CLC participants showed a tendency toward improved confidence in managing hypoglycemia. The INSPIRE questionnaire showed favorable scores in the CLC group for teens and parents, with a similar trend for adults. At baseline and 6 months, CLC participants had high positive expectations for the device with Diabetes Technology Acceptance and SUS showing high benefit and low burden scores. Conclusion: CLC improved some PROs compared with SAP. Participants reported high benefit and low burden with CLC. Clinical Trial Identifier: NCT03563313.

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