The Insulin-Only Bionic Pancreas Improves Glycemic Control in Non-Hispanic White and Minority Adults and Children With Type 1 Diabetes
Authors: Castellanos Luz E. , Russell Steven J. , Damiano Edward R. , Beck Roy W. , Shah Viral N. , Bailey Ryan , Calhoun Peter , Bird Keisha , Mauras Nelly ,   Bionic Pancreas Research Group, Wadwa R. Paul , Forlenza Greg , Slover Robert , Messer Laurel , Cobry Erin , Shah Viral , Polsky Sarit , Jost Emily , Berget Cari , Towers Lindsey , Lange Samantha , Escobar Estella , Beatson Christie , Walker Sonya , Karami Angela , Boranian Emily , Buckingham Bruce , Lal Rayhan , Ekhlaspour Laya , Hughes Michael S. , Basina Marina , Hsu Liana , Hatipoglu Betul , Zhou Keren , Olansky Leann , Surckla Ana , Lomeli Laura , Isaacs Diana , Knapp Shannon , Debs Andrea , Tomaro Tracy , Blanchette Julia , Russell Steven , Sherwood Jordan , Castellanos Luz , Hillard Mallory , Tuffaha Marwa , Putman Melissa , Sands Mollie , Balliro Courtney , Greaux Evelyn , Steiner Barbara , Gaston Sarah , Bartholomew Rachel , Martin Kim , Daniels Mark , Bhangoo Amrit , Forghani Nikta , Kashmiri Himala , Sutton Francoise , Speer Heather , Erickson Marissa , Thompson Samantha , McDaniel Allyson , Raskin Philip , Strowig Suzanne , Jordan Lin , White Perrin , Choudhary Abha , Penn Jimmy , Henson Michael , Molina Yasmin , Nwosu Chantal , Kumar Vanda , Burris Angie , Jernigan Kim , Mann Brittany , Lynch Jane , Jafri Rabab , Rayas Maria , Escaname Elia , Kerr Catherine , Favela-Prezas Ruby , Olivarri Sara , Pettus Jeremy , Boeder Schafer , May Todd , Armstrong Adrienne , Giovanetti Erin , Hirsch Irl , Trikudanathan Subbulaxmi , Sanborn Nancy , Averkiou Xenia , Goland Robin , Williams Kristen , Leibel Natasha , Hyatt Jamie , Pollak Sarah , Robinson Elizabeth , Casciano Emily , Alvarez Analia , Zagoren Eleanor , Johnson Jaclynn , Sharma Silpa , Buse John , Kirkman M. Sue , Bergamo Kate , Klein Klara , Dostou Jean , Machineni Sriram , Young Laura , Diner Jamie , Kass Alex , Purrington Virginia , Fraser Rachel , Uehling Julie , Kruger Davida , Bhan Arti , Jones J. Kimberly , Cushman Terra , Hunter Heather , Corker Natalie , Mukhashen Shereen , Mauras Nelly , Benson Matthew , Bird Keisha , Englert Kimberly , Permuy Joe , Ponthieux Kimberly , Tarko Albina , Muir Andrew , Ham J. Nina , Cossen Kristina , Felner Eric , Antich Amber , Sanchez Wanda , Anzai Mone , Lucas Kathryn , Simpson Catherine , McGill Janet , Salam Maamoun , Silverstein Julie , Adamson Samantha , Cedeno Andrea , Clifton Mary Jane , Schweiger Toni , Bell Traci , Cogen Fran , Meighan Seema , Dauber Andrew , Castro Meryll , McCarthy Tara , Boucher Kimberly , Jenkins Helen , Weissberg-Benchell Jill , Ruedy Katrina , Beck Roy , Borgman Sarah , Bradshaw Sydnee , Miller Paige , Li Zoey , Calhoun Peter , Marek Martin , Pritchard Rosa , Dolzhenko Elizaveta , Damiano Edward R. , El-Khatib Firas H. , Gabrielson Deanna , Idzorek Julie , Elstrom-Park Anne , Arreaza-Rubin Guillermo , Eggerman Thomas , Green Neal , Belle Steven H. , Castle Jessica , Green Jennifer , Legault Laurent , Willi Steven M. , Wysham Carol 
Published: March 2023

OBJECTIVE

We evaluated the performance of the iLet bionic pancreas (BP) in non-Hispanic White individuals (here referred to as “Whites”) and in Black, Hispanic, and other individuals (here collectively referred to as “Minorities”).

RESEARCH DESIGN AND METHODS

A multicenter, randomized controlled trial evaluated glycemic management with the BP versus standard of care (SC) in 161 adult and 165 pediatric participants with type 1 diabetes over 13 weeks.

RESULTS

In Whites (n = 240), the mean baseline-adjusted difference in 13-week HbA1c between the BP and SC groups was −0.45% (95% CI −0.61 to −0.29 [−4.9 mmol/mol; −6.6 to −3.1]; P &lt; 0.001), while this difference among Minorities (n = 84) was −0.53% (−0.83 to −0.24 [−6.0 mmol/mol; −9.2 to −2.8]; P &lt; 0.001). In Whites, the mean baseline-adjusted difference in time in range between the BP and SC groups was 10% (95% CI 7–12; P &lt; 0.001) and in Minorities was 14% (10–18; P &lt; 0.001).

CONCLUSIONS

The BP improves glycemic control in both Whites and Minorities and offers promise in decreasing health care disparities.