Diabetic Ketoacidosis at Onset of Type 1 Diabetes and Glycemic Outcomes with Closed-Loop Insulin Delivery.
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All Authors
Lakshman, R.
Najami, M.
Allen, JM.
Ware, J.
Wilinska, ME.
Hartnell, S.
Thankamony, A.
Randell, T.
Ghatak, A.
Besser, REJ.
LTHT Author
Campbell, Fiona
LTHT Department
Leeds Children's Hospital
Children & Young People's Diabetes
Children & Young People's Diabetes
Non Medic
Publication Date
2024
Item Type
Journal Article
Language
Subject
Subject Headings
Abstract
The presence of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes (T1D) is associated with higher glycated hemoglobin levels over time. We evaluated whether hybrid-closed loop (HCL) therapy from onset of T1D could prevent the adverse impact of DKA at diagnosis on long-term glycemic outcomes. This was a posthoc analysis from 51 adolescents using HCL from diagnosis of T1D as part of the CLOuD trial (NCT02871089). We compared glycemic and insulin metrics between adolescents with (n = 17) and without (n = 34) DKA at diagnosis. Participants with and without DKA at diagnosis had similar time in target glucose range 3.9-10.0 mmol/L (70-180 mg/dL), time below range (<3.9 mmol/L, <70 mg/dL) and HbA1c at 6, 12, and 24 months. While insulin requirements at 6 months were higher in those with DKA at diagnosis, this was not statistically significant after adjusting for bodyweight. Residual C-peptide secretion was similar between groups. We conclude that HCL therapy may mitigate against the negative glycemic effects of DKA at T1D diagnosis.
Journal
Diabetes Technology & Therapeutics