Glycometabolic outcomes in adult type 1 diabetic patients switching to closed-loop systems

Papa, Giuseppe; Cannarella, Rossella; Condorelli, Rosita A.; Finocchiaro, Concetta; Calogero, Aldo E.; La Vignera, Sandro

doi:10.1016/j.diabres.2023.110907

Cited by 1 publication

(3 citation statements)

References 35 publications

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“…The increase in TIR and reduction in TAR represent expected results and are in line with those produced by experimental single-brand and observational clinical studies [ 24 – 26 ]. Specifically, our data showed that following the switch, the average TIR value increased from a suboptimal level to the therapeutic target (> 70%), and this improvement was consistently maintained for 12 months across all three AHCL systems.…”

Section: Discussionsupporting

confidence: 85%

“…There was a routinary transition made in clinical practice, as these are devices successively placed on the market by the same manufacturer, therefore the overall improvement in metrics has been attenuated by the use of an algorithm. The greater reduction of TAR 180-250 could be due to the algorithm of this system, that guarantees superior performance compared to its predecessors in controlling hyperglycemia [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Control-IQ group achieved the most significant reduction in TBR 54-69 probably due to the algorithm of this system and that the glycemic target can be set in a range between 112.5 and 160 mg/dl [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

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Impact on Glycemia Risk Index and other metrics in type 1 adult patients switching to Advanced Hybrid Closed-Loop systems: a one-year real-life experience

Resmini,

Zarra,

Dotti

et al. 2024

Eur J Med Res

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Background Advanced Hybrid Closed-Loop system (AHCL) has profoundly changed type 1 diabetes therapy. This study primarily aimed to assess the impact on Glycemia Risk Index (GRI) and other continuous glucose monitoring (CGM) metrics when switching from one of four insulin strategies to AHCL in type 1 adult patients. Methods A single-center, retrospective pre/post observational study; 198 patients (age 44.4 ± 12.7 years, 115 females/83 males, diabetes duration 24.7 ± 11.6 years, HbA1c 7.4 ± 1%), treated with different insulin therapies (MDI, CSII, SAP with PLGS, HCL) were assessed before and after switching to an AHCL (MiniMed 780G, Diabeloop Roche, Tandem Control-IQ) at 1, 3, 6, and 12 months. Mixed-effects multivariable regression models were used to estimate the mean pre/post variations at different time points, adjusted for potential confounders. Results A month after the switch, there was an improvement in CGM metrics and HbA1c for all patients: GRI −10.7, GMI −0.27%, CV −2.1%, TAR>250 −3.7%, TAR180-250 −5.6%, TIR + 9.7%, HbA1c −0.54% (all p < 0.001). This improvement was maintained throughout the observational period (at 3, 6, and 12 months, with all p-values < 0.001). When improvements across the 780, Diabeloop, and Tandem CIQ devices were compared: Diabeloop demonstrated significantly better performance in terms of GRI, GMI, CV, TAR>250 at T1 (for all p < 0.01); 780 recorded highest average decrease in TAR180-250 (p = 0.020), while Tandem achieved the most significant reduction in TBR54-69 (p = 0.004). Conclusions Adopting an AHCL leads to a rapid and sustained improvement in GRI and other parameters of metabolic control for up to a year, regardless of prior insulin therapies, baseline conditions or brands.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%