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Real-world outcomes with different technology modalities in type 1 diabetes
Pilar I Beato-Víbora1, Fabiola Gallego-Gamero1, Ana Ambrojo-López1
1Endocrinology and Nutrition Department. Badajoz University Hospital, Badajoz, Spain.
Hybrid closed-loop systems (HCL) offer the greatest benefits for type 1 diabetes (T1D) management, significantly improving time in range and reducing hypoglycemia compared to other glucose monitoring and insulin delivery methods. This study highlights HCL as the superior option for glycemic control.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Medical Technology
Background:
- Type 1 diabetes (T1D) management involves various technologies like continuous glucose monitoring (CGM), flash glucose monitoring (FGM), sensor-augmented pumps with predictive low-glucose suspend (SAP-PLGS), and hybrid closed-loop systems (HCL).
- Real-world data is crucial for understanding the comparative benefits of these T1D treatment modalities.
Purpose of the Study:
- To evaluate and compare the real-world effectiveness of different T1D treatment modalities.
- To assess glycemic control, variability, and sensor usage across various technological interventions.
Main Methods:
- A cross-sectional study included 302 individuals with T1D, categorized into four groups based on treatment: CGM + MDI, FGM + MDI, SAP-PLGS, and HCL.
- Data analyzed included time in specific glucose ranges (70-180 mg/dL), hypoglycemia, hyperglycemia, estimated HbA1c, and glycemic variability from 2-week sensor downloads.
Main Results:
- Hybrid closed-loop systems (HCL) demonstrated superior glycemic control, achieving higher time in range (70-180 mg/dL) and reduced hypoglycemia compared to SAP-PLGS.
- CGM + MDI and FGM + MDI groups showed less time in range, more hyperglycemia, and higher glycemic variability than SAP-PLGS.
- HCL outperformed CGM + MDI and FGM + MDI across all evaluated glycemic control and variability metrics.
Conclusions:
- Hybrid closed-loop systems (HCL) provide the maximum real-world benefits for type 1 diabetes management.
- HCL significantly enhances time in range and offers superior protection against hypoglycemia compared to CGM + MDI, FGM + MDI, and SAP-PLGS.
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