Extended use of a closed-loop insulin delivery system at home over a period of 12 weeks without close supervision is feasible in adults, children, and adolescents with type 1 diabetes, a study concludes.

The two 12-week multicentre randomised cross-over trials included 33 adults who wore the systems continuously for 12 weeks, and 25 children and adolescents who used the systems only at night.

For adults the proportion of time that the glycated haemoglobin level was in the target range (primary end point) was significantly greater during the intervention period than during the control period — by a mean of 11.0 percentage points (95% confidence interval [CI], 8.1 to 13.8; P<0.001).

The mean glucose level was significantly lower with day-and-night use of the closed-loop system than with the control system (P<0.001), as was the time spent above the target range (P<0.001).

For the children and adolescents, the proportion of nocturnal time that the glucose level was in the target range was significantly greater during the intervention period than during the control period by a mean of 24.7 percentage points (95% CI, 20.6 to 28.7; P<0.001).

The mean overnight glucose level was significantly lower with the closedloop system than with the control system (P<0.001) as was the time spent above the target range (P<0.001).

One episode of severe hypoglycemia occurred in an adult participant during the intervention period when the closed-loop system was not in use because of loss of connectivity (low battery). One adolescent had two severe hypoglycemic episodes (seizures) when the closedloop system was not in use.

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