Presenter of 2 Presentations
WHICH CHARACTERISTICS ARE ASSOCIATED WITH ATTAINING AN OPTIMAL GLYCEMIC MANAGEMENT AMONG ADULTS LIVING WITH TYPE 1 DIABETES AND USING AUTOMATED INSULIN DELIVERY SYSTEMS?
Abstract
Background and Aims
Automated insulin delivery (AID) systems help people living with type 1 diabetes (T1D) obtain an optimal glycemic management (HbA1c ≤ 7%). However, not every AID user achieved this optimal target. We aim to investigate which characteristics are associated with an optimal glycemic management among adult AID users living with T1D.
Methods
Cross-sectional study using data from the BETTER registry, a registry recruiting participants living with T1D in Quebec, Canada. Inclusion criteria: T1D, aged ≥ 18 y/o, available HbA1c value and not pregnant. Participants were divided into HbA1c ≤ 7% group and HbA1c > 7% group. Student’s t test or chi-square test were used to compare the two groups. Multivariate logistic regression analysis was applied to analyze the associated factors.
Results
The 90 eligible participants (60.0% women) averaged (mean±SD) 43.5 ± 14.5 years old with 26.6 ± 12.5 years of T1D. Comparison between HbA1c ≤ 7% group (N=44) and HbA1c > 7% group (N=46) were shown in Table. Logistic regression analysis suggested that participants with bachelor degree or above (OR 4.18, 95%CI 1.45, 12.03) and with shorter duration of pump use (OR 1.12, 95%CI 1.02, 1.23) were more likely to attain an optimal glycemic management when using an AID, after adjusting for age, sex, body mass index and use frequency of AID (Figure).
Conclusions
Special attention should be given to adult AID users who have a lower educational level and a longer duration of pump use.
COMPARISON OF NOCTURNAL GLUCOSE MANAGEMENT AFTER EXERCISE AMONG DUAL-HORMONE, SINGLE-HORMONE AUTOMATED INSULIN DELIVERY SYSTEM AND USUAL CARE IN TYPE 1 DIABETES: A POOLED ANALYSIS
Abstract
Background and Aims
Only two studies have compared the efficacy of dual-hormone (DH) automated insulin delivery (AID) systems, single-hormone (SH) AID and usual care (UC) on post-exercise overnight glucose management in people living with type 1 diabetes (PWT1D); their conclusions differ. By pooling data from these two studies, we aim to draw stronger conclusions.
Methods
Data were pooled from two open-label, randomized, controlled, crossover studies. Forty-one adults PWT1D [median (Q1-Q3) age: 34.0 years (29.5, 51.0), mean ± SD hbA1c: 7.5 ± 0.2%] and 17 adolescents PWT1D [age: 14.0 (13.0, 16.0), hbA1c: 7.8 ± 0.2%] underwent DH-AID, SH-AID and UC (pump+capillary blood glucose). Each intervention contained an evening, 60-minute, moderate aerobic exercise session. The primary outcome was time in range% (TIR%) overnight (00:00-06:00) post-exercise based on continuous glucose monitoring. The three groups were compared using linear mixed effect model or generalized linear mixed model.
Results
Among adults, TIR% (mean ± SD) was 94.0% ± 11.9%, 83.1% ± 20.5% and 65.1% ± 37.0% during DH-AID, SH-AID and UC intervention, respectively (P<0.05 for all between-group comparisons) (Table 1). DH-AID was superior to SH-AID and UC, and SH-AID was superior to UC regarding hypo- and hyperglycemia prevention but not glycemic variability. Among adolescents, DH-AID and SH-AID were both superior to UC regarding hypo- and hyperglycemia prevention but not glycemic variability (Table 2). Glycemic outcomes were similar between DH-AID and SH-AID (P>0.05).
Conclusions
Regarding post-exercise nocturnal glucose management, AIDs were both better than UC for both adult and adolescent PWT1D; DH-AID was better than SH-AID among adult but not adolescent PWT1D.