Cari Berget, United States of America
University of Colorado Barbara Davis CenterPresenter of 1 Presentation
HCL USE DECREASES SIGNIFICANTLY ACROSS TIME IN YOUTH WITH T1D
Abstract
Background and Aims
The aim of this study was to describe HCL use in a clinical sample of youth using the 670G and identify an HCL use threshold associated with meeting A1c target of 7.5% at 12 months
Methods
Youth starting the 670G HCL system for T1D care participated in a 12-month observational study. Data on HCL use and glycemic outcomes were obtained from pump downloads and chart review during routine clinic visits in the first 12 months after starting HCL.
Results
Ninety-three youth (14.7±3.7 yrs.;50% M;A1c 8.8±1.7%) with T1D for 6.8 (4.6,10.0) yrs. started HCL. HCL use was 69% 1 month after starting HCL, which declined to 52% at month 6 and 47% at month 12 (p<0.001). Sensor use declined from 78% at month 1 to 65% at month 6 and 55% at month 12 (p<0.001). Sensor TIR (70-180 mg/dL) declined from 61% at month 1, to 56% at month 6, and 54% at month 12 (p<0.05). Forty-six youth (49%) discontinued HCL within the first 12 months of use. ROC analysis identified 69% as the HCL use threshold associated with A1c ≤7.5% (AUC=0.76;specificity=63%;sensitivity= 84%).
Conclusions
HCL use ≥69% may be a clinical goal to increase likelihood of meeting A1c target of 7.5% in youth with T1D using 670G HCL. However, the decline in HCL and sensor use across time, and 50% HCL discontinuation rate, suggests youth struggle to sustain HCL use. Future developments in HCL technology should prioritize ease of HCL use to prevent discontinuation and ensure the benefits of HCL technology are realized in the real-world.