Performance of a dual-hormone closed-loop system versus insulin-only closed-loop system in adolescents with type 1 diabetes. A single-blind, randomized, controlled, crossover trial

Emilie Bundgaard Lindkvist, Christian Laugesen, Asbjørn Thode Reenberg, Tobias Kasper Skov Ritschel, Jannet Svensson, John Bagterp Jørgensen, Kirsten Nørgaard, Ajenthen G. Ranjan


ObjectiveTo assess the efficacy and safety of a dual-hormone (DH [insulin and glucagon]) closed-loop system compared to a single-hormone (SH [insulin only]) closed-loop system in adolescents with type 1 diabetes.MethodsThis was a 26-hour, two-period, randomized, crossover, inpatient study involving 11 adolescents with type 1 diabetes (nine males [82%], mean ± SD age 14.8 ± 1.4 years, diabetes duration 5.7 ± 2.3 years). Except for the treatment configuration of the DiaCon Artificial Pancreas: DH or SH, experimental visits were identical consisting of: an overnight stay (10:00 pm until 7:30 am), several meals/snacks, and a 45-minute bout of moderate intensity continuous exercise. The primary endpoint was percentage of time spent with sensor glucose values below range (TBR [ResultsOverall, there were no differences between DH and SH for the following glycemic outcomes (median [IQR]): TBR 1.6 [0.0, 2.4] vs. 1.28 [0.16, 3.19]%, p=1.00; time in range (TIR [3.9-10.0 mmol/L]) 68.4 [48.7, 76.8] vs. 75.7 [69.8, 87.1]%, p=0.08; and time above range (TAR [>10.0 mmol/L]) 28.1 [18.1, 49.8] vs. 23.3 [12.3, 27.2]%, p=0.10. Mean ( ± SD) glucose was higher during DH than SH (8.7 ( ± 3.2) vs. 8.1 ( ± 3.0) mmol/L, pConclusionsDH and SH performed similarly in adolescents with type 1 diabetes during a 26-hour inpatient monitoring period involving several metabolic challenges including feeding and exercise. However, during the night and around exercise, the SH configuration outperformed DH.
Original languageEnglish
Article number1073388
JournalFrontiers in Endocrinology
Pages (from-to)1073388
Publication statusPublished - 23 Jan 2023


  • Adolescent
  • Blood Glucose/metabolism
  • Cross-Over Studies
  • Diabetes Mellitus, Type 1/drug therapy
  • Glucose
  • Humans
  • Insulin
  • Male
  • Single-Blind Method
  • moderate intensity continuous exercise
  • type 1 diabetes mellitus
  • adolescents
  • advanced hybrid closed-loop
  • non-linear model predictive control
  • dual-hormone
  • artificial pancreas

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