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In adults, poor control Type 1 diabetes For people with type 1 diabetes who use an insulin pump and continuous glucose monitoring (CGM), switching to an automated insulin administration (AID) system can have a measurable effect on blood glucose levels within 14 weeks.
- Even with insulin pumps and CGM, many people with type 1 diabetes A1c ≤ 7% (53 mmol/mol), which is important to prevent or delay complications.
- This open-label randomized controlled trial trial We evaluated the effect of the AID system on 40 participants (mean age 52 years, 45% male, diabetes duration 29 years, mean A1c value 8.3%) recruited between June 2021 and September 2022 from the outpatient clinic of the Steno Diabetes Centre, Copenhagen.
- Participants were randomly assigned to receive either treatment with the MiniMed 780G (Medtronic, USA) (AID group, n = 20) or usual care ( Insulin pumps and CGM (usual care group, n = 20) for 14 weeks, after which all participants in both groups received treatment with AIDs for an additional 14 weeks.
- The primary outcome was the difference between treatment groups in the change from baseline to week 14 in time in range (TIR) (3.9-10.0 mmol/L), assessed using 2 weeks of CGM data.
- Secondary outcomes were change in A1c and mean sensor glucose levels, differences in change in time above and below range, and other glycemic parameters.
- At week 14, the TIR in the AID group increased by 18.7%, compared with -2.1% in the usual care group (P < .0001)。TIR > 70% was achieved by 80% of participants in the AID group and 10% of participants in the usual care group.
- Similarly, extreme hyperglycemic time, average sensor glucose level, and A1c level (all P (< .0001) was significantly reduced in the AID group compared with the usual care group, and no severe symptoms were reported. Hypoglycemia Under research.
- At week 14, patient-reported outcomes, as measured by Diabetes Treatment Satisfaction Questionnaire scores, frequency of hyperglycemia, and fear of hypoglycemia, were better in the AID group than in the usual care group.
- At week 28, TIR and A1c levels in the usual care group improved similarly after switching to AID at week 14, whereas these glycemic parameters remained stable in the AID group.
“These findings support the incorporation of AID use as standard of care for adults with type 1 diabetes who struggle to achieve glycemic goals, regardless of previous technology use,” the authors write.
The study was led by Merete B. Christensen, MD, PhD, of the Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Herlov, Denmark. Published In Journal of Diabetes Science and Technology.
The study duration was not long enough to detect rare adverse events. The study population was ethnically diverse, so the results may not be generalizable. Only participants who used a daily bolus calculator were included.
This investigator-initiated study was supported in part by an unrestricted grant from Medtronic A/S. Some authors have declared speaker fees, lecture fees, honoraria for serving on advisory boards, consultancy fees, and stock holdings from pharmaceutical or medical technology companies. One author reports being employed by Novo Nordisk during the conduct of the study.