{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T07:51:56Z","timestamp":1791445916158,"version":"4.3.3"},"reference-count":37,"publisher":"Walter de Gruyter GmbH","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2024-0312_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Hybrid closed-loop (HCL) systems improve glycemic control in type 1 diabetes mellitus (T1D), but their effectiveness in young, poorly controlled populations is not\u00a0established and requires study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2024-0312_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A pre\u2013post study was performed using electronic health records of patients 3\u201324 years with baseline HbA<jats:sub>1c<\/jats:sub>\u22659\u202f% prescribed HCL within the New York City Health+Hospitals System assessing HbA<jats:sub>1c<\/jats:sub> levels and hospitalizations before and after HCL initiation and factors associated with achieving HbA<jats:sub>1c<\/jats:sub>&lt;9\u202f% after HCL\u00a0initiation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2024-0312_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 47 children and adolescents who met inclusion criteria, 4.68\u202f% female, 95.72\u202f% non-White, and 82.22\u202f% covered by public insurance, with a baseline average HbA<jats:sub>1c<\/jats:sub>\u00a010.6\u202f% (2.28 IQR). The most prevalent pump type was\u00a0Omnipod 5 (70.21\u202f%). The HbA<jats:sub>1c<\/jats:sub> was significantly lower\u00a0in\u00a0the postperiod than baseline (HbA<jats:sub>1c<\/jats:sub> before=median 10.6 (IQR2.28), HbA<jats:sub>1c<\/jats:sub> after=median 9.33 (IQR 2.97), difference 1.00 (IQR 1.64), p&lt;0.05) with a decrease in median diabetes-related hospitalizations (preperiod 1.00 (IQR 1.00), postperiod 0.00 (IQR 1.00), difference\u00a0\u22121.00, IQR 2, p&lt;0.05). Lower baseline HbA<jats:sub>1c<\/jats:sub> levels made reaching HbA<jats:sub>1c<\/jats:sub>&lt;9\u202f% more likely. Multivariable analysis showed that\u00a0the odds of having HbA<jats:sub>1c<\/jats:sub> of &lt;9\u202f% was 2.1 times less likely for every one point increase in baseline HbA<jats:sub>1c<\/jats:sub> and 12.5 times less likely for those with a pump at (p&lt;0.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2024-0312_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>HCL therapy improved glycemic control and decreased diabetes-related hospitalizations in youth with poorly controlled T1DM. Higher baseline HbA<jats:sub>1c<\/jats:sub> levels predicted less success with HCL therapy so those who stand\u00a0to benefit most benefit least.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2024-0312","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T12:30:35Z","timestamp":1730723435000},"page":"1028-1035","source":"Crossref","is-referenced-by-count":4,"title":["Do hybrid closed loop insulin pump systems improve glycemic control and reduce hospitalizations in poorly controlled type 1 diabetes?"],"prefix":"10.1515","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0264-9721","authenticated-orcid":false,"given":"Ilham","family":"Farhat","sequence":"first","affiliation":[{"name":"Pediatric Endocrinology, Department of Pediatrics , SUNY Downstate Health Sciences University , Brooklyn , NY , USA"},{"name":"Department of Pediatrics , NYC Health + Hospitals\/Harlem Hospital , New York , NY , USA"},{"name":"Pediatric Endocrinology, Department of Pediatrics , NYC Health + Hospitals\/Kings County Hospital, South Brooklyn Hospital , Brooklyn , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shah","family":"Drishti","sequence":"additional","affiliation":[{"name":"St. George\u2019s University , Saint George , Grenada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risa","family":"Bochner","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , NYC Health + Hospitals\/Harlem Hospital , New York , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renee","family":"Bargman","sequence":"additional","affiliation":[{"name":"Pediatric Endocrinology, Department of Pediatrics , NYC Health + Hospitals\/Kings County Hospital, South Brooklyn Hospital , Brooklyn , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2024,11,5]]},"reference":[{"key":"2024120211230926169_j_jpem-2024-0312_ref_001","doi-asserted-by":"crossref","unstructured":"Foster, NC, Beck, RW, Miller, KM, Clements, MA, Rickels, MR, DiMeglio, LA, et al.. 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Safety of a hybrid closed-loop insulin delivery system in patients with type 1 diabetes. JAMA 2016;316:1407\u20138. https:\/\/doi.org\/10.1001\/jama.2016.11708.","DOI":"10.1001\/jama.2016.11708"},{"key":"2024120211230926169_j_jpem-2024-0312_ref_015","doi-asserted-by":"crossref","unstructured":"Tauschmann, M, Thabit, H, Bally, L, Allen, JM, Hartnell, S, Wilinska, ME, et al.. APCam11 Consortium. Closed-loop insulin delivery in suboptimally controlled type 1 diabetes: a multicentre, 12-week randomised trial. Lancet. 2018;392:1321-9. Erratum in: Lancet. 2018 Oct 13;392(10155):1310. 10.1016\/S0140-6736(18)32477-2. https:\/\/doi.org\/10.1016\/S0140-6736(18)31947-0 [Epub 2018 Oct 3].","DOI":"10.1016\/S0140-6736(18)31947-0"},{"key":"2024120211230926169_j_jpem-2024-0312_ref_016","doi-asserted-by":"crossref","unstructured":"Choudhary, P, Kolassa, R, Keuthage, W, Kroeger, J, Thivolet, C, Evans, M, et al.. 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J Fam Pract 2023;72:S13\u201318. https:\/\/doi.org\/10.12788\/jfp.0568.","DOI":"10.12788\/jfp.0568"},{"key":"2024120211230926169_j_jpem-2024-0312_ref_019","doi-asserted-by":"crossref","unstructured":"Zhou, K, Isaacs, D. Closed-loop artificial pancreas therapy for type 1 diabetes. Curr Cardiol Rep 2022;24:1159\u201367. https:\/\/doi.org\/10.1007\/s11886-022-01733-1 [Epub 2022 Jun 21].","DOI":"10.1007\/s11886-022-01733-1"},{"key":"2024120211230926169_j_jpem-2024-0312_ref_020","doi-asserted-by":"crossref","unstructured":"Peacock, S, Frizelle, I, Hussain, S. A systematic review of commercial hybrid closed-loop automated insulin delivery systems. Diabetes Ther 2023;14:839\u201355. https:\/\/doi.org\/10.1007\/s13300-023-01394-5 [Epub 2023 Apr 5].","DOI":"10.1007\/s13300-023-01394-5"},{"key":"2024120211230926169_j_jpem-2024-0312_ref_021","doi-asserted-by":"crossref","unstructured":"Brown, SA, Forlenza, GP, Bode, BW, Pinsker, JE, Levy, CJ, Criego, AB, et al.. 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Performance of medtronic hybrid closed-loop iterations: results from a randomized trial in adolescents with type 1 diabetes. Diabetes Technol Therapeut 2018;20:693\u20137. https:\/\/doi.org\/10.1089\/dia.2018.0161 [Epub 2018 Sep 11].","DOI":"10.1089\/dia.2018.0161"},{"key":"2024120211230926169_j_jpem-2024-0312_ref_033","doi-asserted-by":"crossref","unstructured":"Pease, A, Zomer, E, Liew, D, Lo, C, Earnest, A, Zoungas, S. Cost-effectiveness of health technologies in adults with type 1 diabetes: a systematic review and narrative synthesis. Syst Rev 2020;9:171. https:\/\/doi.org\/10.1186\/s13643-020-01373-y.","DOI":"10.1186\/s13643-020-01373-y"},{"key":"2024120211230926169_j_jpem-2024-0312_ref_034","doi-asserted-by":"crossref","unstructured":"Fox, DS, Ware, J, Boughton, CK, Allen, JM, Wilinska, ME, Tauschmann, M, et al.. 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Diabetes Technol Therapeut 2023;25:864\u201376. https:\/\/doi.org\/10.1089\/dia.2023.0297.","DOI":"10.1089\/dia.2023.0297"},{"key":"2024120211230926169_j_jpem-2024-0312_ref_036","doi-asserted-by":"crossref","unstructured":"Lambadiari, V, Ozdemir Saltik, AZ, de Portu, S, Buompensiere, MI, Kountouri, A, Korakas, E, et al.. Cost-effectiveness analysis of an advanced hybrid closed-loop insulin delivery system in people with type 1 diabetes in Greece. Diabetes Technol Therapeut 2022;24:316\u201323. https:\/\/doi.org\/10.1089\/dia.2021.0443.","DOI":"10.1089\/dia.2021.0443"},{"key":"2024120211230926169_j_jpem-2024-0312_ref_037","doi-asserted-by":"crossref","unstructured":"Roze, S, Buompensiere, MI, Ozdemir, Z, de Portu, S, Cohen, O. Cost-effectiveness of a novel hybrid closed-loop system compared with continuous subcutaneous insulin infusion in people with type 1 diabetes in the UK. 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