The psychosocial outcomes of advanced hybrid closed-loop system in children and adolescents with type 1 diabetes

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dc.authoridKose, Sezen/0000-0001-6631-9549
dc.contributor.authorJalilova, Arzu
dc.contributor.authorPilan, Birsen Senturk
dc.contributor.authorDemir, Gunay
dc.contributor.authorOzbaran, Burcu
dc.contributor.authorBalki, Hanife Gul
dc.contributor.authorArslan, Emrullah
dc.contributor.authorKose, Sezen Gokcen
dc.date.accessioned2024-08-31T07:46:54Z
dc.date.available2024-08-31T07:46:54Z
dc.date.issued2024
dc.departmentEge Üniversitesien_US
dc.description.abstractThe study was carried out to determine the psychosocial outcomes of advanced hybrid closed-loop (AHCL) systems in children and adolescents with type 1 diabetes (T1D). Single-center and cohort study with a duration 6 months consisted of 60 children and adolescents with T1D. Standard clinical procedures, including both glycemic indicators, e.g., sensor-measured time within the 70-180 mg/dL range and glycated hemoglobin (HbA1c) levels, and psychosocial metrics were used for data collection. The psychosocial metrics included the Pediatric Quality of Life Inventory (PedsQL) 3.0 Diabetes Module for both children (8-12 years) and parents; the Quality of Life for Youth scale for adolescents (13-18 years); the Strengths and Difficulties Questionnaire (SDQ); the Hypoglycemia Fear Survey for Children (HFS-C); the Revised Child Anxiety and Depression Scale (R-CADS); and AHCLS-specific DTSEQ satisfaction and expectation survey. These metrics were evaluated at the baseline and after 6 months of AHCL use. Of the 60 children and adolescents with T1D for whom the AHCL system was utilized, 41 of them, 23 female and 18 male, completed the surveys. The mean age of the 41 children and adolescents was 12.5 +/- 3.2 (min. 6.7, max. 18) years. The time spent within the target glycemic range, i.e., time-in-range (TIR), improved from 76.9 +/- 9% at the baseline to 80.4 +/- 5% after 6 months of AHCL system use (p = 0.03). Additionally, HbA1c levels reduced from 7.1% +/- 0.7% at the baseline to 6.8% +/- 0.8% after 6 months of AHCL system use (p = 0.03). The most notable decline in HbA1c was observed in participants with higher baseline HbA1c levels. All patients' HFS-C and AHCL system-specific DTSEQ satisfaction and expectation survey scores were within the normal range at the baseline and remained unchanged during the follow-up period. No significant difference was found in the R-CADS scores of children and adolescents between baseline and after 6 months of AHCL system use. However, there was a significant decrease in the R-CADS scores of the parents. Patients' PedsQL scores were high both at the baseline and after 6 months. The SDQ scores were high at baseline, and there was no significant improvement at the end of 6 months. Conclusion: This is the first study to investigate in detail the psychosocial outcomes of AHCL system use in T1D patients and their parents. Although state-of-the-art technologies such as AHCL provide patients with more flexibility in their daily lives and information about glucose fluctuations, the AHCL resulted in a TIR above the recommended target range without a change in QOL, HFS-C, SDQ, and R-CADS scores. The scores obtained from the R-CADS conducted by the parents of the children indicated that the use of pumps caused a psychological improvement in the long term, with a significant decrease in the R-CADS scores of the children and adolescents with T1D. What is Known: center dot Previous studies focused on clinical outcomes of AHCL systems in pediatric T1D patients, showing glycemic control improvements. center dot Limited attention given to psychosocial outcomes of AHCL systems in children and adolescents with T1D. center dot Crucial psychosocial factors like quality of life, emotional well-being, and fear of hypoglycemia underexplored in AHCL system context. What is New: center dot First study to comprehensively examine psychosocial outcomes of AHCL systems in pediatric T1D patients. center dot Study's robust methodology sets new standard for diabetes technology research and its impact on qualiy of life.en_US
dc.description.sponsorshipEge Universityen_US
dc.description.sponsorshipNo Statement Availableen_US
dc.identifier.doi10.1007/s00431-024-05551-1
dc.identifier.endpage3103en_US
dc.identifier.issn0340-6199
dc.identifier.issn1432-1076
dc.identifier.issue7en_US
dc.identifier.pmid38661816en_US
dc.identifier.scopus2-s2.0-85191448413en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage3095en_US
dc.identifier.urihttps://doi.org/10.1007/s00431-024-05551-1
dc.identifier.urihttps://hdl.handle.net/11454/104225
dc.identifier.volume183en_US
dc.identifier.wosWOS:001208227700002en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.relation.ispartofEuropean Journal of Pediatricsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.snmz20240831_Uen_US
dc.subjectAdvanced Hybrid Closed-Loopen_US
dc.subjectType 1 Diabetesen_US
dc.subjectPsychosocial Outcomesen_US
dc.subjectPediatric Endocrinologyen_US
dc.subjectGlycemic Controlen_US
dc.titleThe psychosocial outcomes of advanced hybrid closed-loop system in children and adolescents with type 1 diabetesen_US
dc.typeArticleen_US

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