PROSPECTIVE EVALUATION OF THE IMPACT OF HYBRID CLOSED-LOOP SYSTEM ON GLYCAEMIC CONTROL, GLYCAEMIC VARIABILITY AND PATIENT-RELATED OUTCOMES IN CHILDREN AND ADULTS IN SPAIN

Session Name
E-POSTER DISCUSSION 07
Session Type
E-POSTER DISCUSSION
Date
21.02.2020, Friday
Session Time
10:05 - 10:25
Channel
Station 1 (E-Poster Area)
Lecture Time
10:10 - 10:15
Presenter
  • Pilar Isabel Beato víbora, Spain
Authors
  • Pilar Isabel Beato víbora, Spain
  • F Gallego-gamero, Spain
  • L Lázaro-martín, Spain
  • MM Romero-pérez, Spain
  • FJ Arroyo-díez, Spain

Abstract

Background and Aims

The aim was to evaluate the outcomes of hybrid closed-loop system in children and adults with type 1 diabetes.

Methods

Patients consecutively starting hybrid closed-loop system (MiniMed-670G) were evaluated in a prospective longitudinal design (baseline, 3-months, 6-months). HbA1c, time in range (TIR) 70-180mg/dl, time >180mg/dl, >250mg/dl, <70mg/dl and <54mg/dl in 2-week downloads were recorded. Glycaemic variability measures were calculated. Adolescents and adults completed a set of questionnaires (Gold and Clarke scores, Hypoglycemia Fear Survey [HFS], Diabetes Quality of Life [DQoL], Diabetes Treatment Satisfaction [DTS], Diabetes Distress Scale [DDS], Pittsburgh Sleep Quality Index [PSQI]).

Results

58 patients were included, age: 28±15 years (7-63), <18 years-old: 38% (n=22), 59% (n=34) females, diabetes duration: 15±9 years, previous treatment: sensor-augmented pump with predictive low glucose suspend (SAP-PLGS): 60% (n=35) (median time: 3.2 years [1.7-3.7]), pump+SMBG: 19% (n=11), MDI+SMBG: 12% (n=7), MDI+CGM: 9% (n=5).

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At 3 months, number of auto-mode exits: 4±2/patient-week (0.6±0.3/patient-day), time in auto-mode: 85±17%, alarms: 8.5±3.7/day. Improvement in TIR was not different in children compared to adults, previous pump or CGM users compared to non-users. Baseline HbA1c and baseline TIR were predictors of improvement in TIR. In patients with baseline high hypoglycaemia risk (n=29), time in hypoglycaemia range was significantly reduced. At 6 months (n=21), HbA1c and TIR 70-180 mg/dl improved compared to baseline (HbA1c: 6.9±0.4% vs 7.3±0.7%, p=0.003, TIR: 73±8% vs 64±11%, p<0.001). Discontinuation rate was 3% (n=2).

Conclusions

Real-world use of hybrid closed-loop systems improves glycaemic control, reduces glycaemic variability and ameliorates diabetes burden in children and adults with type 1 diabetes.

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