RSS-Feed abonnieren
PDF herunterladen
DOI: 10.1055/s-0044-1787111
The Efficiency of an Advanced Hybrid Closed Insulin Pump in Patients with Type 1 Diabetes for Improved Blood Glucose Control
Autor*innen
Funding and Sponsorship None.
Abstract
Background Diabetes technology, especially advanced hybrid closed-loop (AHCL) systems, is rapidly advancing, offering improved glycemic control, reduced hypoglycemia, and reduced treatment burden for patients with type 1 diabetes (T1D). This study aimed to evaluate the clinical efficiency of an AHCL system—the Medtronic MiniMed 780G insulin pump combined with continuous glucose monitoring—among individuals with T1D in real-world clinical settings.
Methods In an observational retrospective study, we identified a cohort of 41 patients (mean age, 47.1 ± 13.7 years; T1D duration, 23.6 ± 13 years; 73.2% female) previously using an insulin pump or those on multiple daily insulin injections, currently using the AHCL system for at least 6 months. Primary outcomes were the changes of the following parameters, before AHCL initiation and at 6 months after treatment; (1) time in range (TIR): time with glucose levels in the range of 70 to 180 mg/dL, (2) time below range (TBR): time with glucose levels below 70 mg/dL, and (3) time above range (TAR): time with glucose levels above 180 mg/dL.
Results Data analysis from 41 patients showed a significant 16.5% ± 13.8% increase in TIR (from 56.6 ± 17.9 to 73.1 ± 10.6%, p < 0.001). Both TBR and TAR decreased by 2.9 ± 4.8% (p = 0.004) and 13.6 ± 16.4% (p < 0.001), respectively. Mean glucose concentration, coefficient of variation, and glucose management indicator significantly improved.
Conclusion The AHCL system effectively improved glucose control regarding TIR, TBR, and TAR. Enhanced glycemic control metrics highlight the potential for wider adoption of AHCL technology.
Author's Contributions
All the named authors participated in data collection and analysis and drafting and revising the manuscript.
Compliance with Ethical Principles
County Durham and Darlington Foundation NHS Trust approved the study.
Publikationsverlauf
Artikel online veröffentlicht:
11. Juli 2024
© 2024. The Libyan Biotechnology Research Center. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Rubin RR, Peyrot M. Quality of life and diabetes. Diabetes Metab Res Rev 1999; 15 (03) 205-218
- 2 Nathan DM, Zinman B, Cleary PA. et al; Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Research Group. Modern-day clinical course of type 1 diabetes mellitus after 30 years' duration: the diabetes control and complications trial/epidemiology of diabetes interventions and complications and Pittsburgh epidemiology of diabetes complications experience (1983-2005). Arch Intern Med 2009; 169 (14) 1307-1316
- 3 Charleer S, Mathieu C, Nobels F. et al; RESCUE Trial Investigators. Effect of continuous glucose monitoring on glycemic control, acute admissions, and quality of life: a real-world study. J Clin Endocrinol Metab 2018; 103 (03) 1224-1232
- 4 U.S. Food and Drug Administration. Artificial pancreas device system [Internet]. Accessed April 2, 2024 at: https://www.fda.gov/medical-devices/consumer-products/artificial-pancreas-device-system
- 5 Griffin TP, Gallen G, Hartnell S. et al. UK's Association of British Clinical Diabetologist's Diabetes Technology Network (ABCD-DTN): best practice guide for hybrid closed-loop therapy. Diabet Med 2023; 40 (07) e15078
- 6 Phillip M, Nimri R, Bergenstal RM. et al. Consensus recommendations for the use of automated insulin delivery (AID) technologies in clinical practice. Endocr Rev 2023; 44 (02) 254-280
- 7 Knoll C, Peacock S, Wäldchen M. et al. Real-world evidence on clinical outcomes of people with type 1 diabetes using open-source and commercial automated insulin dosing systems: a systematic review. Diabet Med 2022; 39 (05) e14741
- 8 Kumareswaran K, Elleri D, Allen JM. et al. Meta-analysis of overnight closed-loop randomized studies in children and adults with type 1 diabetes: the Cambridge cohort. J Diabetes Sci Technol 2011; 5 (06) 1352-1362
- 9 Usoh CO, Johnson CP, Speiser JL, Bundy R, Dharod A, Aloi JA. Real-world efficacy of the hybrid closed-loop system. J Diabetes Sci Technol 2022; 16 (03) 659-662
- 10 Boughton CK, Hartnell S, Thabit H. et al. Hybrid closed-loop glucose control compared with sensor augmented pump therapy in older adults with type 1 diabetes: an open-label multicentre, multinational, randomised, crossover study. Lancet Healthy Longev 2022; 3 (03) e135-e142
- 11 Aleppo G, Webb KM. Integrated insulin pump and continuous glucose monitoring technology in diabetes care today: a perspective of real-life experience with the Minimed™ 670G hybrid closed-loop system. Endocr Pract 2018; 24 (07) 684-692
- 12 Silva JD, Lepore G, Battelino T. et al. Real-world performance of the MiniMed™ 780G system: first report of outcomes from 4120 users. Diabetes Technol Ther 2022; 24 (02) 113-119
- 13 Battelino T, Danne T, Bergenstal RM. et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Diabetes Care 2019; 42 (08) 1593-1603
- 14 National Diabetes Audit. Care processes and treatment targets, overview [Internet]. Accessed at February 1, 2024: https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-audit/core-1-2021-22-overview#summary