{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Royston C"],"funding":["National Institute for Health Research (NIHR)"],"pagination":["1008-1013"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC7618672"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["27(12)"],"pubmed_abstract":["<b><i>Objective:</i></b> To evaluate trends in insulin delivery and day-to-day variability of insulin requirements over 48 months of hybrid closed-loop use following diagnosis of type 1 diabetes (T1D) in individuals aged 10-16 years. <b><i>Methods:</i></b> A secondary analysis of the closed-loop arm of an open-label, multicenter, randomized, parallel hybrid closed-loop trial assessing closed-loop insulin delivery in newly diagnosed children and adolescents with T1D was conducted. Mean total daily dose (TDD) over 24 h and during the night, as well as mean total basal and bolus insulin over 24 h, were calculated. Day-to-day variability of insulin requirements was evaluated over 24 h and at night. <b><i>Results:</i></b> TDD increased from 27.2 ± 16.1 units/d (mean ± standard deviation) at 0-3 months following diagnosis to 65.7 ± 24.9 units/d at 42-48 months. The proportion of total daily insulin delivered as basal insulin rose from 41% to 61% over 48 months. Day-to-day variability of insulin requirements after diagnosis was high (coefficient of variation at 0-3 months: 23.3 ± 0.9%) and remained stable over 48 months. No clinically relevant sex-based differences were observed in insulin requirements. <b><i>Conclusions:</i></b> During the first 48 months after diagnosis of T1D, insulin requirements in children and adolescents more than double with hybrid closed-loop insulin delivery. Over time, a greater proportion of insulin is administered via the closed-loop algorithm, and the high day-to-day variability in insulin needs underscores the importance of initiating adaptive closed-loop systems from diagnosis."],"journal":["Diabetes technology & therapeutics"],"pubmed_title":["Trends in Total Daily Dose and Variability of Insulin Requirements in Newly Diagnosed Children and Adolescents with Type 1 Diabetes over 48 Months."],"pmcid":["PMC7618672"],"funding_grant_id":["14/23/09"],"pubmed_authors":["Hartnell S","Allen JM","Wilinska ME","Randell T","Ware J","Boughton CK","Royston C","Ghatak A","CLOuD Consortium","Besser REJ","Campbell FM","Elleri D","Hovorka R","Thankamony A","Trevelyan N"],"additional_accession":[]},"is_claimable":false,"name":"Trends in Total Daily Dose and Variability of Insulin Requirements in Newly Diagnosed Children and Adolescents with Type 1 Diabetes over 48 Months.","description":"<b><i>Objective:</i></b> To evaluate trends in insulin delivery and day-to-day variability of insulin requirements over 48 months of hybrid closed-loop use following diagnosis of type 1 diabetes (T1D) in individuals aged 10-16 years. <b><i>Methods:</i></b> A secondary analysis of the closed-loop arm of an open-label, multicenter, randomized, parallel hybrid closed-loop trial assessing closed-loop insulin delivery in newly diagnosed children and adolescents with T1D was conducted. Mean total daily dose (TDD) over 24 h and during the night, as well as mean total basal and bolus insulin over 24 h, were calculated. Day-to-day variability of insulin requirements was evaluated over 24 h and at night. <b><i>Results:</i></b> TDD increased from 27.2 ± 16.1 units/d (mean ± standard deviation) at 0-3 months following diagnosis to 65.7 ± 24.9 units/d at 42-48 months. The proportion of total daily insulin delivered as basal insulin rose from 41% to 61% over 48 months. Day-to-day variability of insulin requirements after diagnosis was high (coefficient of variation at 0-3 months: 23.3 ± 0.9%) and remained stable over 48 months. No clinically relevant sex-based differences were observed in insulin requirements. <b><i>Conclusions:</i></b> During the first 48 months after diagnosis of T1D, insulin requirements in children and adolescents more than double with hybrid closed-loop insulin delivery. Over time, a greater proportion of insulin is administered via the closed-loop algorithm, and the high day-to-day variability in insulin needs underscores the importance of initiating adaptive closed-loop systems from diagnosis.","dates":{"release":"2025-01-01T00:00:00Z","publication":"2025 Dec","modification":"2026-06-14T05:44:41.922Z","creation":"2026-06-14T03:09:17.838Z"},"accession":"S-EPMC7618672","cross_references":{"pubmed":["40803607"],"doi":["10.1177/15209156251369882"]}}