Use of a do-it-yourself artificial pancreas system is associated with better glucose management and higher quality of life among adults with type 1 diabetes

Abstract

Background: Previous studies show that the use of do-it-yourself artificial pancreas system (DIYAPS) may be associated with better glycemic control characterized by improved estimated hemoglobin A1c (eHbA1c) and time in range among adults with type 1 diabetes (T1D). However, few studies have demonstrated the changes in laboratory-measured HbA1c, which is a more accepted index for glycemic control, after using a DIYAPS. Methods: This is a retrospective before-after study approaching patients who reported self-use of AndroidAPS. The main inclusion criteria included: T1D; aged ⩾18 years; having complete record of ⩾3 months of continuous AndroidAPS use; with laboratory-measured HbA1c and quality of life scale data before and after 3 months of AndroidAPS use; and not pregnant. The primary outcome was the change in HbA1c between baseline and 3 months after initiation of AndroidAPS use. Results: Overall, 15 patients (10 females) were included; the median age was 32.2 years (range: 19.2–69.4), median diabetes duration was 9.7 years (range: 1.8–23.7) and median baseline HbA1c was 7.3% (range: 6.4–10.1). The 3 months of AndroidAPS use was associated with substantial reductions in HbA1c [6.79% (SD: 1.29) versus 7.63% (SD: 1.06), p = 0.002] and glycemic variability when compared with sensor-augmented pump therapy. A lower level of fear of hypoglycemia [22.13 points (SD: 6.87) versus 26.27 points (SD: 5.82), p = 0.010] was also observed after using AndroidAPS. Conclusions: The 3 months of AndroidAPS use was associated with significant improvements in glucose management and quality of life among adults with T1D.

Association of British Clinical Diabetologists, Diabetes Technology Network UK and Association of Children’s Diabetes Clinicians Survey of UK Healthcare Professional Attitudes Towards Open-Source Automated Insulin Delivery Systems

“…The OS-AID community believe these systems are safe and effective based on the available user data [ 7 ]. Recent reviews of the evidence highlight high levels of user satisfaction and quality of life outcome measures are positive, with excellent self-reported outcomes [ 8 , 9 ]. Validated safety and efficacy outcomes have also been reported with encouraging results from a study of Loop in the USA and a recent real-world comparison between MedTronic MiniMed 670G and OS-AID systems in UK [ 7 , 8 , 10 , 11 ].…”

Real‐world evidence on clinical outcomes of people with type 1 diabetes using open‐source and commercial automated insulin dosing systems: A systematic review

“…target glucose, different profiles, insulin absorption model, remote monitoring and remote control for caregivers of children). Two small studies investigated the effectiveness of AndroidAPS 16,42 :…”

How It Started, How It Is Going: The Future of Artificial Pancreas Systems (Automated Insulin Delivery Systems)

“…5-8 These open source closed loop systems reduce hyperglycemia without increasing hypoglycemia 9 and improve quality of life. 10 They have been studied not only in retrospective and observational studies 11,12 but also in silico 13 as well as ongoing, randomized control trials. 14…”