Real-World Experience With Automated Insulin Pump Technology in Veterans With Type 1 Diabetes.

Area of Science:

• Endocrinology
• Geriatric Medicine
• Medical Technology

Background:

• Diabetes technology, including insulin pumps and continuous glucose monitors (CGM), is increasingly integrated into clinical care.
• Automated insulin pumps (AIP) offer automated insulin delivery based on real-time CGM data.
• While proven effective in younger populations, the safety and efficacy of AIP in older adults with type 1 diabetes mellitus (T1DM) remain less understood.

Purpose of the Study:

• To assess the real-world safety and viability of automated insulin pump (AIP) technology in an older veteran population with T1DM.
• To evaluate the impact of AIP on glycemic control and patient engagement in self-management.

Main Methods:

• A pilot study involving 37 T1DM patients new to AIP at the Malcom Randall VA Medical Center.
• Data collected included demographics, clinical data, and insulin pump/CGM metrics before and after AIP initiation.
• Patients used the Medtronic Minimed 670G Insulin Pump System between March and December 2018.

Main Results:

• The mean age of participants was 59.1 years, with a mean T1DM duration of 25.3 years.
• Transition to AIP was safe, with no increase in hypoglycemia.
• Mean hemoglobin A1c levels decreased from 7.6% to 7.3% by the second follow-up visit.

Conclusions:

• Automated insulin pump (AIP) use is a safe and viable option for managing T1DM in older veterans.
• AIP technology enhanced patient engagement in blood sugar monitoring and improved glycemic control.
• Further long-term, large-scale studies are warranted to confirm these findings.