Use of the first approved hybrid closed loop device in type 1 diabetes (T1D) is linked to improved glycemic outcomes. However, discontinuation of Automode is high due to patient reported usability challenges. Our aim is to assess the effect of patient training on Medtronic 670G use.
Data were obtained from a retrospective chart review of T1D pediatric patients who attended at least one training session for the 670G system between 2016-2018. Twelve-month average HbA1cs before and after the final training date were obtained in addition to ‘full’ (3 out of 3 sessions) or ‘partial’ (1-2 sessions) training. Data were analyzed with Fisher’s exact and paired Wilcoxon signed rank tests.
Twenty-five subjects (mean±SD) 17.2±3.5 years old with T1D duration 9.1±4.7 years underwent training for pump, CGM, and/or Automode initiation; 13/25 (52%) completed full training; 9/25 completed two, and 3/25 only one. All subjects (100%) with full training and 33% with partial training were using Automode at the time of analysis (p=0.0005). There were no significant differences in average HbA1c from pre- to post-Automode between groups (p=0.8548).
Subjects with complete training were more likely to be using Automode. HbA1c did not differ between subjects who received full or partial training. This may be due to the small sample size and wide variability of HbA1c values. Future direction will include assessment of time in range, sensor wear, and user satisfaction to guide sustainable integration of diabetes education and technology training and its relationship to improved care.