BEGOÑA Pla peris, Spain
HOSPITAL UNIVERSITARIO DE LA PRINCESA ENDOCRINOLOGY AND NUTRITIONPresenter of 1 Presentation
CLOSING THE LOOP FOR DIABETES: OUR CLINICAL EXPERIENCE WITH THE USE OF ARTIFICIAL PANCREAS SYSTEM ALMOST ELIMINATING HYPOGLYCEMIAS.
Abstract
Background and Aims
INTRODUCTION: Diabetes technology improves glycaemic control. However, hypoglycaemia remains the main challenge for optimizing it. Integrated systems such as Do It Yourself (DIY) Artificial Pancreas (AP), known worldwide although not FDA approved, can be a major breakthrough in overcoming this barrier.
Methods
METHODS: We present data from a patient using DIY AP (hybrid closed-loop system) consisting of a Roche Combo pump with faster insulin aspart (Fiasp), linked to Dexcom G6 CGM and an open source app that acts as an AP system (Android APS). Real time access to CGM data is provided via Nightscout Open Source (CGM in the cloud). We compare glycaemic data before and after AP system.
Results
RESULTS: 42-year-old male with type 1 DM. Diabetes duration of 28 years, basal-bolus insulin therapy Degludec/Lispro, with good metabolic control but high frequency of hypoglycaemias. Last 3 months FreeStyle Libre Flash CGM readings showed: Mean of 15 scans/day. Estimated Hba1c 5.5%.228 low glucose events. 104 min of time spent in hypoglycaemia. Time in range (TIR) 77% (70-180 mg/dl), 16% below and 7% above target. Hypoglycaemic events were systematically more than 3/day, several of them <54 mg/dl, various were severe. With AP system, Nightscout 3 months reporting showed a significant improve in TIR (77% to 93.2%), and in low values (16% to 4.0%), these averaged 61.1 +/- 6.9 mg/dl. Estimated Hba1c 5.4%.0 severe hypoglycaemias.
Conclusions
CONCLUSION: Elimination of hypoglycaemia is a major challenge in type 1 DM. AP system shows promising results demonstrating a reduction in hypoglycaemia, improving glycaemic control and quality of life.