Evidence map›Paper›PMID 39797667›Full record

Trial reportBMJ open diabetes research & care2024

Six months of hybrid closed-loop therapy improves diabetes-specific positive well-being, and reduces diabetes distress and fear of hypoglycemia: secondary analysis of a randomized controlled trial.

Jennifer A Halliday, Sienna Russell-Green, Benjamin Lam, Steven Trawley, Sybil A McAuley, Leon A Bach, Morton G Burt, Neale D Cohen, Peter G Colman, Elizabeth A Davis and 15 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in BMJ open diabetes research & care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Allogeneic Islet Transplantation: Chronicle of a Death Foretold?Transplant international : official journal of the European Society for Organ Transplantation · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors.

Jennifer A HallidayInstitute for Health Transformation, Deakin University, Geelong, Victoria, Australia j.halliday@deakin.edu.au.ORCID 0000-0003-1156-279X
Sienna Russell-GreenThe Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Carlton, Victoria, Australia.
Benjamin LamThe Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Carlton, Victoria, Australia.
Steven TrawleyThe Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Carlton, Victoria, Australia.
Sybil A McAuleyThe Cairnmillar Institute, Melbourne, Victoria, Australia.ORCID 0000-0001-7035-489X
Leon A BachDepartment of Endocrinology and Diabetes, The Alfred, Melbourne, Victoria, Australia.
Morton G BurtSouthern Adelaide Diabetes and Endocrine Services, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Neale D CohenSchool of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
Peter G ColmanDepartment of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
Elizabeth A DavisDepartment of Endocrinology and Diabetes, Perth Children's Hospital, Perth, Western Australia, Australia.
Deborah Jane Holmes-WalkerSydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-3640-1370
Alicia J JenkinsDepartment of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
Joey KayeDepartment of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
Anthony C KeechNHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia.
Melissa H LeeDepartment of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
Roland W McCallumDepartment of Diabetes and Endocrinology, Royal Hobart Hospital, Hobart, Tasmania, Australia.
Barbora PaldusDepartment of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
Stephen N StranksSouthern Adelaide Diabetes and Endocrine Services, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Vijaya SundararajanDepartment of Public Health, La Trobe University, Melbourne, Victoria, Australia.
Glenn WardDepartment of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
Timothy W JonesDepartment of Endocrinology and Diabetes, Perth Children's Hospital, Perth, Western Australia, Australia.
David O'NealDepartment of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
Jane SpeightInstitute for Health Transformation, Deakin University, Geelong, Victoria, Australia.ORCID 0000-0002-1204-6896
Christel HendrieckxThe Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Carlton, Victoria, Australia.
Australian JDRF Closed-Loop Research Group Members

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis analysis aimed to investigate diabetes-specific psychological outcomes among adults with type 1 diabetes (T1D) using hybrid closed-loop (HCL) versus standard therapy. RESEARCH DESIGN AND

methodsIn this multicenter, open-label, randomized, controlled, parallel-group clinical trial, adults with T1D were allocated to 26 weeks of HCL (MiniMed™ 670G) or standard therapy (insulin pump or multiple daily injections without real-time continuous glucose monitoring). Psychological outcomes (awareness and fear of hypoglycemia; and diabetes-specific positive well-being, diabetes distress, diabetes treatment satisfaction, and diabetes-specific quality of life (QoL)) were measured at enrollment, mid-trial and end-trial. Linear mixed models were conducted, using restricted maximum likelihood estimation, unadjusted and adjusted (for covariates: age, sex, diabetes duration, glycated hemoglobin, recent severe hypoglycemia, pre-trial insulin delivery modality, enrollment and mid-study scores).

results120 participants (mean age 44±12 years) were randomized to intervention (n=61) or standard therapy (n=59). At 13 weeks, the HCL group had better diabetes-specific positive well-being than the standard therapy group (unadjusted: Δ=1.0, p=0.025; adjusted: Δ=1.1, p=0.01), which was maintained at 26 weeks (unadjusted: Δ=0.9, p=0.042; adjusted: Δ=1.0, p=0.023). At 26 weeks, the HCL group also had less diabetes distress (adjusted: Δ=-6.4, p=0.039), fear of hypoglycemia ("maintain high": adjusted: Δ=-0.8, p=0.034; and "worry": adjusted: Δ=-1.8, p=0.048), and perceived "unacceptably high glucose levels" (unadjusted: Δ=-1.1, p<0.001; adjusted: Δ=-1.1, p<0.001). HCL did not improve diabetes treatment satisfaction, diabetes-specific QoL, hypoglycemia awareness, or perceived frequency of unacceptably low glucose levels.

conclusionsThese findings imply that HCL offers important psychological benefits. In particular, improvement in diabetes-specific positive well-being was observed 13 weeks after HCL initiation and maintained at 26 weeks. Reduction in the perceived frequency of hyperglycemia was also apparent by 26 weeks. Adjusted analyses showed significant reductions in diabetes distress and fear of hypoglycemia at 26 weeks, suggesting these benefits were apparent for people with particular characteristics. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry: ACTRN12617000520336.

Indexed as

Diabetes Mellitus, Type 1FearHypoglycemiaHypoglycemic AgentsInsulinInsulin Infusion SystemsQuality of LifeAdultBiomarkersBlood GlucoseBlood Glucose Self-MonitoringFemaleFollow-Up StudiesGlycated HemoglobinHumansMaleBiomarkersBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsInsulinArtificial PancreasDiabetes Mellitus, Type 1Patient Reported Outcome Measures

Identifiers

PMID39797667
PMCPMC11683942

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.