Impact of 6-months of an advanced hybrid closed-loop system on sleep and psychosocial outcomes in youth with type 1 diabetes and their parents

• Published in: Diabetes research and clinical practice Vol. 207; p. 111087
• Main Authors: Cobry, Erin C., Pyle, Laura, Karami, Angela J., Sakamoto, Casey, Meltzer, Lisa J., Jost, Emily, Towers, Lindsey, Paul Wadwa, R.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.01.2024
• Subjects: Hybrid closed-loop systems; Parents; Pediatrics; Quality of life; Sleep; Type 1 diabetes; Pediatrics; Sleep; Type 1 diabetes; Hybrid closed-loop systems; Parents; Quality of life
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2023.111087

•Nocturnal time in range, time hyperglycemia, and average sensor glucose significantly improved following initiation of an advanced hybrid closed loop system.•Hypoglycemia fear, pediatric quality of life, and parent diabetes-related distress improved significantly after initiation of an advanced hybrid closed loop system.•Parent sleep improved after the child initiated an advanced hybrid closed-loop system (PSQI and wake after sleep onset). Youth with type 1 diabetes (T1D) and parents experience reduced quality of life and sleep quality due to nocturnal monitoring, hypoglycemia fear, and diabetes-related disruptions. This study examined the sleep and quality of life impact of advanced technology. Thirty-nine youth with T1D, aged 2–17 years, starting an advanced hybrid closed-loop (HCL) system and a parent participated in an observational study. Surveys, actigraphy, sleep diaries, and glycemic data (youth) were captured prior to HCL, at one week, 3 months, and 6 months. Outcomes were modeled using linear mixed effects models with random intercepts to account for within-subject correlation, with least-squares means at each timepoint compared to baseline. Parents and youth reported improvements in health-related quality of life and fear of hypoglycemia after HCL initiation. Concurrently, nocturnal glycemia improved. Actigraphy-derived sleep outcomes showed improved 6 month adolescent efficiency and 3 and 6 month parent wake after sleep onset. Additionally, parents reported improved subjective sleep quality and child sleep-related impairment at 3 months. With nocturnal glycemic improvements in youth using HCL technology, some aspects of parent and youth sleep and quality of life improved. This may reflect decreased parental monitoring and worry and highlights benefits for youth beyond glycemia.