Hypoglycemia reduction and improvement of its perception is a goal for pump therapy. We evaluated the time spent bellow hypoglycemia treshold and awareness of it in adults with T1D on SAP with PLGS (Minimed 640G®) in real life.
All patients that went through a 6 week initiation program and with more than 6 months of SAP-PLGS Therapy at our clinic were invited. Times bellow 70 and 54 mg/dL (TBR70 and TBR54) for the last month were obtained from the pump, and it was compared to TBR70 from a CGM used for applying for pump coverage. Current Clarke questionnaire was self-administered and it was compared with results obtained before initiation. Proper statistic tests, according to comparison sample size, were used.
78 subjects were included with mean age 34.3 ± 14.0 years and 16.8 ± 9.6 years of disease duration. Current TBR70 for the whole sample was 3.6 ± 2.1% and TBR54 0.7 ± 0.8%, with no significant differences according to length of follow-up. In the 29 patients that we could obtain previous CGM data, pre pump TBR was 12.6 ± 6.4% compared to 3.1 ± 1.6 on the most recent follow-up on pump therapy (p<0.001). When examining the whole sample and classifying by Clarke test, 60.0% of patients have good recognition, 15.4% are undetermined and 25.6% have hypoglycemia unawareness compared with 29.9%, 29.9% and 40.2%, respectively, at inititation (p=0.001).
Adults with T1D on SAP-PLGS succesfully reduce TBR to consensus goals and improve hypoglycemia perception with management by a multidisciplinary team.