Closed Loop

Association of British Clinical Diabetologists

Closed Loop Nationwide Audit

 
Home Live ABCD audits of new therapies and devices All ABCD nationwide audits Future audits of new therapies ABCD worldwide audits
     
Graphic showing closed loop system

Above – a graphic from JDRF website – closed-loop insulin delivery systems require an insulin pump, continuous glucose monitor and an algorithm on a smart device. This algorithm uses the glucose data to make decisions on insulin delivery to maintain glucose levels within a pre-specified target level. When used in the real world What are the benefits? What are the problems? Are there any dangers? – the audit could tell us.

 
Clossed Loop HbA1c

Sustained improvement in HbA1c in individuals with above target HbA1c starting closed-loop in the ADAPT trial 

 
Hybrid Closed Loop

Graphical abstract for the ABCD DTN-UK Closed-Loop Audit from the NHS England pilot published in Diabetes Care

 
CAM-APS Trial Data

Above – In the clinical trial, glucose levels with the CAM APS FX system were significantly lower than with standard pump therapy, especially overnight. Will these improvements occur when the same system is used in the real world – the audit could tell us. click the link to see the paper reporting the clinical trial

 
Tandem Control IQ Trial Data

Above – In the clinical trial, compared with sensor augmented pump therapy with low glucose suspend, the Tandem Control IQ automated delivery system demonstrated reductions in HbA1c and reductions in time-below-range. Will these improvements occur when the same system is used in the real world – the audit could tell us - click the link to see the paper reporting the clinical trial

 
MedTronic 780G clinical trial data

Above - In the clinical trial, the MedTronic 780G closed-loop, much like the other available systems, was associated with improved glucose levels overnight compared to sensor augmented pump therapy with predictive low glucose suspend alone. Will these improvements occur when the same system is used in the real world – the audit could tell us - click the link to see the paper reporting the clinical trial

 

ABCD Closed-Loop Audit

This is the NEW tool for individuals commencing closed-loop outside of the pilot. This could be in connection with the new NICE Technology Appraisals or individuals using closed-loop already for previous indications. For individuals wishing to submit follow-up data for the NHS England Pilot please follow this link: Click here
Following the success of our existing audits in diabetes technology, including the audit of the NHS England closed loop pilot, this audit of closed-loop users is planned to launch to coincide with the new NICE Technology Appraisal and broader access to this vital technology.

About the ABCD DTN-UK Closed-Loop audit
A secure online tool is currently being built to for the collection of data in this audit. In the meantime, Centres with closed loop users can collect data using the baseline and follow up forms in paper format (see links on the right) ready to enter in bulk into the online tool once it becomes available. We would encourage centres to collect data prospectively using these forms. You will be informed as soon as the online tool is available which should be in late 2023. The baseline and follow-up forms can also be used for retrospective data collection of those already using closed-loop systems and that data can also be added to the on-line tool.

Web-based audit tool
The online audit tool will be held on the Health and Social Care Network (HSCN - formerly called N3) – the internal NHS IT system. All data is anonymous, encrypted and GDPR compliant. As this audit is on HSCN, it can only be accessed from an NHS computer system. The tool will facilitate both local analysis and nationwide data analysis.

Structure of the audit – centres and sites
For this audit the concept of centres and sites is utilised in the same way as in the other ABCD audits. Typically, a centre might be an NHS Trust. Sites might be hospitals associated with that Trust. Designated centre leads can download their local anonymised data for analysis.

Collect data on-line or via paper forms
The on-line audit tool is intended to be easy to use such that live data entry in clinic is a real option to be considered. Alternatively, if preferred, to facilitate data collection during clinics there are paper forms which exactly match the data that can be entered into the audit tool. The baseline registration form should be completed alongside a follow-up form if being completed retrospectively. You can download and print these forms locally via the link (see links on the left to download the forms).

Caldicott Guardian approval
The ABCD nationwide audit programme has Caldicott Guardian approval. The programme is audit not research. The NHS encourages audit of clinical practice and there are strict guidelines which we follow, in particular that we only to collect data from routine clinical practice, and analysis is of data which is anonymised.

Further information
The Further enquiries may be made to the ABCD nationwide audits database administrator of the project, Melissa Cull

Clinical Audit Leads
Dr Emma Wilmot, Derby
Dr Bob Ryder, Birmingham
Dr Tom Crabtree, Derby
Dr Alex Liarakos, Derby
Dr Alistrair Lumb, Oxford
Professor Pratik Choudhary, Leicester

 

   Register for ABCD closed loop audit

Access the on-line tool

Closed Loop audit objectives

Download baseline visit standard form

Download follow up visit standard form

Papers, abstracts, presentations, posters from the audit

Further information- contact us

ABCD on N3 homepage

Main ABCD homepage

The ABCD Closed-Loop Nationwide audit is an independent audit supported by unrestricted grants from Dexcom, Abbott, Insulet

Working to support high quality diabetes care in the UK