title: The effects of inpatient hybrid closed-loop therapy initiated within 1 week of type 1 diabetes diagnosis.
abstract: BACKGROUND
  This article describes our experience with inpatient hybrid closed-loop control (HCLC) initiated shortly after the diagnosis of type 1 diabetes in a randomized trial designed to assess the effectiveness of inpatient HCLC followed by outpatient sensor-augmented pump (SAP) therapy on the preservation of β-cell function.
  
  
  METHODS
  Forty-eight individuals with newly diagnosed type 1 diabetes and positive pancreatic autoantibodies (7.8-37.7 years old) received inpatient HCLC therapy for up to 93 h, initiated within 7 days of diagnosis.
  
  
  RESULTS
  On initiation of HCLC, mean glucose concentration was 240±100 mg/dL. During the first day of HCLC, median of the participant's mean glucose concentrations fell rapidly to 146 mg/dL, a level of control that was sustained on Days 2 and 3 (138 mg/dL and 139 mg/dL, respectively). By Day 3, the median percentage of glucose values >250 and <60 mg/dL was <1%. During the first 2 weeks of SAP treatment at home, the median participant mean glucose level was 126 mg/dL (interquartile range, 117, 137 mg/dL), and the median percentage of values between 71 and 180 mg/dL was 85% (interquartile range, 80%, 90%).
  
  
  CONCLUSIONS
  Inpatient HCLC followed by outpatient SAP therapy can provide a safe and effective means to rapidly reverse glucose toxicity and establish near-normal glycemic control in patients with newly diagnosed type 1 diabetes.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Buckingham
authors.forename: Roy W
authors.initials: RW
authors.lastname: Beck
authors.forename: Katrina J
authors.initials: KJ
authors.lastname: Ruedy
authors.forename: Peiyao
authors.initials: P
authors.lastname: Cheng
authors.forename: Craig
authors.initials: C
authors.lastname: Kollman
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Weinzimer
authors.forename: Linda A
authors.initials: LA
authors.lastname: DiMeglio
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Bremer
authors.forename: Robert
authors.initials: R
authors.lastname: Slover
authors.forename: Martin
authors.initials: M
authors.lastname: Cantwell
mesh_terms: D061605:Administration, Intravenous; D000293:Adolescent; D000328:Adult; D000465:Algorithms; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007297:Inpatients; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin