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Long‐term real‐life glycaemic outcomes with a hybrid closed‐loop system compared with sensor‐augmented pump therapy in patients with type 1 diabetes
Author(s) -
Akturk Halis Kaan,
Giordano Dominique,
Champakanath Anagha,
Brackett Scott,
Garg Satish,
SnellBergeon Janet
Publication year - 2020
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.13933
Subject(s) - medicine , type 1 diabetes , insulin pump , continuous glucose monitoring , closed loop , insulin delivery , diabetes mellitus , gastroenterology , surgery , endocrinology , control engineering , engineering
Aim To compare glycaemic metrics at 3 and 6 months in patients with type 1 diabetes on a 670G hybrid closed‐loop (HCL) system after using a sensor‐augmented pump (SAP) for at least 3 months. Materials and Methods A retrospective study from a centre that has the largest number of 670G users in the United States was conducted. Data from 202 SAP users were reviewed. Sixty‐one patients were excluded (two for steroid use, four for pregnancy, 27 for previous Enlite use, and 28 for non‐continuous use of 670G). Out of 141 patients who met the inclusion criteria, 127 (aged 21–68 years) had complete data. Results HbA1c levels decreased by 0.4% at 3 months and were maintained at 6 months (7.6 ± 0.07 vs. 7.2 ± 0.08, P < 0.001) with no weight gain at 6 months. Time‐in‐range (70–180 mg/dL) increased from 59.5% ± 1.1% to 70.2% ± 1.2% and 70.1% ± 1.1% at 3 and 6 months ( P < 0.001), respectively. At 6 months, time spent in hypoglycaemia (<70 mg/dL) and time spent in hyperglycaemia (>180 mg/dL) were reduced by 30% (2.2% ± 0.2% vs. 3.2% ± 0.2%; P < 0.05) and 26% (28.3% ± 1.2% vs. 38.1% ± 1.2%; P < 0.001), respectively. More time in auto‐mode was associated with improved continuous glucose monitoring metrics, lower HbA1c and decreased glycaemic variability. Time in auto‐mode declined in men after 3 months, while women maintained similar auto‐mode use throughout the study. Conclusions The HCL system improved HbA1c levels and time‐in‐range, and decreased time spent in hypoglycaemia and hyperglycaemia at 6 months. Auto‐mode use was significantly correlated with continuous glucose monitoring metrics and glycaemic outcomes.