Abstract
Background and Aims
Previous studies show that do-it-yourself hybrid closed-loop (DIY-HCL) is associated with better glycemic control, but were largely biased by usage of estimated hemoglobin A1c (HbA1c) in the analyses. We aimed to assess the effect of using one of the DIY-HCLs, AndroidAPS among adults with type 1 diabetes (T1D) with documented data.
Methods
This was a retrospective study, approaching participants with T1D who reported self-use of AndroidAPS from T1D China Registry Study. We included those met criteria below into analysis: aged >18 years; having complete record of ≥three-month continuous use of AndroidAPS (version2.0 enabling super micro bolus and un-announced meal features, with Bluetooth-enabled continuous glucose monitoring systems and pumps); with documented HbA1c and Quality of life (QoL) records before and after three-month use of AndroidAPS; and not pregnant. All included participants provided written informed consent. Pair t test or chi-squared test was adopted to compare variables before and after use of AndroidAPS.
Results
149 participants were screened and ten included in analysis (six female, median age:34.1 years [range:20.1-69.4], median diabetes duration:13.0 years[2.7-23.7], median HbA1c:7.3%[6.4-8.8]). Data of the first three-month of using AndroidAPS were analyzed, as shown in the Table. Use of AndroidAPS was associated with decreased HbA1c(7.37±0.83%vs.6.53±0.48%,P=0.003), prolonged time in target(50.14±8.68%vs.62.43±8.7%,P<0.001) and time in range(76.30±7.61%vs.84.75±6.33%,P=0.001), and less glycemic fluctuation. Lower level of fear of hypoglycemia was also observed after using AndroidAPS, together with seemingly less time in hypoglycemia(P=0.055). No severe hypoglycemia or diabetic ketoacidosis occurred.
Conclusions
Use of DIY-HCL was associated with improved glycemic control, glycemic variability and QoL among adults with T1D.
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