Abstract
Background and Aims
Predictive low-glucose suspend (PLGS) insulin delivery system and hybrid closed loop (HCL) systems may improve glucose control in type 1 diabetic individuals. This is a single-center, retrospective, observational study to evaluate the effect on metabolic control and glucose variability of PLGS and HCL systems compared to sensor-augmented pump (SAP) therapy.
Methods
We retrospectively analyzed seventy-nine adults with type 1 diabetes on insulin pump therapy, matched for age, gender and BMI. The mean follow-up was 3.5±1.9 years.
Results
Forty patients (mean age 51,2±16,1 years, F/M 19/21), who are in treatment with HCL system (Minimed 670G, Medtronic, Northridge, CA) or with PLGS feature (Minimed 640G, Medtronic, Northridge, CA) (Group 1), were compared to 39 subjects in SAP therapy (mean age 47,8±10,5 years, F/M 15/24) (Group 2). Group 1, compared to Group 2, showed lower HbA1c levels (7.2±0.8% vs 7.6±0.9%, p=0.07), and a statistically significant higher percentage of time that interstitial glucose level was within the target range, defined as 70 to 180 mg per deciliter (65.3±12.4% versus 56.1±16.4%, p=0.03). Moreover, Group 1 showed a significant lower time spent in hypoglycemic range compared to Group 2 (2.0±1.7% versus 6.7±5.6%, p=0.001).
Conclusions
PLGS and HCL systems were more effective in improving glucose control and in reducing the risk of hypoglycaemia in patients with type 1 diabetes, thereby mitigating risk for acute and chronic complications.
