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Peer-reviewedCC BY-NC-NDTrials

STABILOOP, a cohort trial to assess automated insulin delivery in the management of patients living with type 1 diabetes who are eligible for islet transplantation.

2 more authors
10 affiliations
  1. 1Univ. Grenoble Alpes, Inserm U1055, Department of Pharmacy, Grenoble Alpes University Hospital, LBFA, Grenoble, France. [email protected].
  2. 2Univ. Grenoble Alpes, Inserm, U1300 - HP2, CIC1406, Grenoble Alpes University Hospital, Grenoble, France.
  3. 3Univ. Montpellier, Inserm U1191, CNRS UMR5203, Department of endocrinology and diabetes, University hospital of Montpellier, Montpellier, France.
  4. 4Univ. Lyon, Department of nephrology, immunology and transplantation, Hospices civils de Lyon, Lyon, France.
  5. 5Univ. Toulouse, Department of Diabetology, Metabolic Diseases and Nutrition, University hospital of Toulouse, Toulouse, France.
  6. 6Univ. Lyon, Department of endocrinology, diabetology and nutrition, Hospices civils de Lyon, Lyon, France.
  7. 7Univ. Strasbourg, Inserm UMR 1260, Department of endocrinology and diabetology, University hospital of Strasbourg, Regenerative nanomedicine federation of translational medicine, Strasbourg, France.
  8. 8Univ. Paris Cité, INSERM UMR-S1151, CNRS UMR-S8253, Department of Diabetes and Endocrinology, Hôpital Lariboisière, APHP, Immunity and Metabolism in Diabetes Team, Paris, France.
  9. 9Univ. Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble INP, Institute of Engineering Univ. Grenoble Alpes, TIMC, Grenoble, 38000, France.
  10. 10Univ. Grenoble Alpes, Inserm U1055, Department of Diabetology, Endocrinology and Nutrition, Grenoble Alpes University Hospital, LBFA, Grenoble, France.

Abstract

Introduction

A limited subset of people living with type 1 diabetes (T1D) is affected by extreme glycemic lability and frequent unpredictable severe hypoglycemia, significantly impairing quality of life and associated with higher morbidity, mortality, and healthcare costs. Islet transplantation (IT) has demonstrated efficacy in stabilizing glucose control and preventing severe hypoglycemia in these people, but it carries risks related to the procedure and chronic immunosuppression. Automated insulin delivery (AID) has emerged as a new standard of care for T1D, offering significant improvements in glycemic control. However, the efficacy of AID in patients with high glucose variability, who are eligible for IT, remains poorly evaluated. This study aims to assess the suitability of AID as a therapeutic option for these people.Methods and analysis

This prospective, multicenter cohort study involves six clinical centers experienced in both IT and AID systems. All patients referred for unstable T1D management will be considered for enrollment. According to patient's preference, registration for IT will be processed after inclusion, or AID will be initiated and IT could be later processed according to AID outcomes. Data will include clinical, glucose control, and quality of life assessments over a follow-up period of up to 4 years. For study analysis, participants will be categorized into three groups: (1) patients immediately registered for IT, (2) patients achieving improved glycemic stability under AID, and (3) patients in whom AID fails to achieve adequate glycemic control. The primary endpoint is the proportion of patients experiencing severe hypoglycemia under AID therapy. Secondary endpoints include changes in glucose metrics based upon continuous glucose monitoring (CGM), quality of life measurements, clinical evolution, and the medico-economic impact of IT versus AID.Discussion

This first study of AID in patients eligible for islet transplantation includes clinical, psychosocial, and economic outcomes. Its strengths are the comprehensive evaluation and real-world design. Findings will support evidence-based guidance for treating severe glycemic instability in T1D.Trial registration

n°38RC24.0169, NCT07006272, name: Cohort Study to Refine the Positioning of Closed-loop Therapy Versus Islet Transplantation in the Management of Patients With Unstable Type 1 Diabetes, Version 1.0_10.12.24. Registered on June 5, 2025.

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BibTeX
@article{perrier2026stabiloop,
  title = {{STABILOOP, a cohort trial to assess automated insulin delivery in the management of patients living with type 1 diabetes who are eligible for islet transplantation.}},
  author = {Quentin Perrier and Matthieu Roustit and Orianne Villard and Fanny Buron and Hélène Hanaire and Amal Lemoine and Luc Rakotoarisoa and Laurence Kessler and Laurent Meyer and Jean-Pierre Riveline and Eric Renard and Sandra David-Tchouda and Pierre-Yves Benhamou and Sandrine Lablanche},
  journal = {Trials},
  year = {2026},
  month = aug,
  doi = {10.1186/s13063-026-09930-x},
  url = {https://europepmc.org/article/MED/42968108},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - STABILOOP, a cohort trial to assess automated insulin delivery in the management of patients living with type 1 diabetes who are eligible for islet transplantation.
AU  - Quentin Perrier
AU  - Matthieu Roustit
AU  - Orianne Villard
AU  - Fanny Buron
AU  - Hélène Hanaire
AU  - Amal Lemoine
AU  - Luc Rakotoarisoa
AU  - Laurence Kessler
AU  - Laurent Meyer
AU  - Jean-Pierre Riveline
AU  - Eric Renard
AU  - Sandra David-Tchouda
AU  - Pierre-Yves Benhamou
AU  - Sandrine Lablanche
PY  - 2026
DA  - 2026/08/01
JO  - Trials
DO  - 10.1186/s13063-026-09930-x
UR  - https://europepmc.org/article/MED/42968108
AB  - Introduction  A limited subset of people living with type 1 diabetes (T1D) is affected by extreme glycemic lability and frequent unpredictable severe hypoglycemia, significantly impairing quality of life and associated with higher morbidity, mortality, and healthcare costs. Islet transplantation (IT) has demonstrated efficacy in stabilizing glucose control and preventing severe hypoglycemia in these people, but it carries risks related to the procedure and chronic immunosuppression. Automated insulin delivery (AID) has emerged as a new standard of care for T1D, offering significant improvements in glycemic control. However, the efficacy of AID in patients with high glucose variability, who are eligible for IT, remains poorly evaluated. This study aims to assess the suitability of AID as a therapeutic option for these people.Methods and analysis  This prospective, multicenter cohort study involves six clinical centers experienced in both IT and AID systems. All patients referred for unstable T1D management will be considered for enrollment. According to patient's preference, registration for IT will be processed after inclusion, or AID will be initiated and IT could be later processed according to AID outcomes. Data will include clinical, glucose control, and quality of life assessments over a follow-up period of up to 4 years. For study analysis, participants will be categorized into three groups: (1) patients immediately registered for IT, (2) patients achieving improved glycemic stability under AID, and (3) patients in whom AID fails to achieve adequate glycemic control. The primary endpoint is the proportion of patients experiencing severe hypoglycemia under AID therapy. Secondary endpoints include changes in glucose metrics based upon continuous glucose monitoring (CGM), quality of life measurements, clinical evolution, and the medico-economic impact of IT versus AID.Discussion  This first study of AID in patients eligible for islet transplantation includes clinical, psychosocial, and economic outcomes. Its strengths are the comprehensive evaluation and real-world design. Findings will support evidence-based guidance for treating severe glycemic instability in T1D.Trial registration  n°38RC24.0169, NCT07006272, name: Cohort Study to Refine the Positioning of Closed-loop Therapy Versus Islet Transplantation in the Management of Patients With Unstable Type 1 Diabetes, Version 1.0_10.12.24. Registered on June 5, 2025.
SN  - 1745-6215
ER  -