Background and Aims

Increasing usage of continuous glucose monitoring (CGM) and recognition of the limitations of HbA1c lead to the adoption of new key metabolic parameters. Better understanding is needed as they are imposed as main metrics for the evaluation of patients with T1D.

Aim: To evaluate the correlation between time in range (TIR), hyperglycemia, estimated HbA1c and conventionally measured HbA1c.

Methods

A total of 43 families with child/children with T1D on pump treatment and continuous use of CGM were invited to participate in the study;31 (72.1%) families accepted.The children were followed for 6 months.Data from CGM was downloaded for 14 days 3-monthly.

Results

The study group consists of 32 children with T1D,mean age 9.3±3.4y, 20(64.5%) boys,mean diabetes duration 4.9±1.9y; 24 (77.4%) of all are on sensor-augmented pump therapy; 5(16.1%) on OpenAPS and 2 (6.5%) are on the LOOP system.Mean duration of CGM usage is 3.0±1.3y. Mean HbA1c improved significantly at 6 months as follows: 6.9±1.0% vs. 6.8±1.0% (p =0.003).TIR strongly negatively correlated with HbA1c (baseline r=-0.77, 6th month r=-0.8) and with eHbA1c (r =-0.9, 3^rd monthr =-0.8, 6^th month r= -0.9).Time spent in hyperglycemia above 14 mmol/l influenced metabolic control only at the end of follow up period (r=0.8).Relationship between eHba1c and measured HbA1c is significant at the final evaluation (r=0.9, p=0.003).

Conclusions

There is strong correlation of eHbA1C, TIR and measured HbA1c which renders these key metrics preferred for assessing of an individual patient's glycemic control. Further studies may lead to their exclusive use also for predicting of the risk of diabetes complications.

Background and Aims

In the last 5 years usage of automatic insulin delivery systems is increasing among patients with T1D. It has been shown that they improve metabolic control, decrease time spent in hypoglycemia and episodes of nocturnal hypoglycemia, increase time spent in target and are feasible and safe.

Aim: To evaluate benefits in children/adolescents using do it yourself (DIY) unapproved loops vs sensor-augmented pump therapy (SAP).

Methods

A total of 43 families with child/children with T1D on pump treatment and continuous use of CGM were invited to participate in the study;31 (72.1%) families accepted.The children were followed for 196 patient months.

Results

The study group consists of 31 children with T1D;24 of all are on SAP;7 use DIY loops. No differences were observed in both groups for age, duration of diabetes and daily insulin dose(Tabl.1) Patients on DIY loops spent significantly more time in range(83 vs 68.8%,p=0.02),less time in hyperglycemia above 14 mmol/l (2.1vs 8.6%,p=0.02) and have better HbA1c at 6^th month(6.5 vs 7.2%,p=0.006 ) vs SAP patients for the follow-up period.No severe hypoglycemia and DKA occurred.There are no gender differences between and within both groups.

Tabl.1

Conclusions

DIY unregistered loops systems show promising results for better metabolic control without increasing the risk of severe hypoglycemia and DKA at least in terms of mean BGLs. Further impact e.g. consumed fat/protein, insulin dose,macro- and microvascular complications,etc.,remain to be studied in larger and longer studies.