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Glycemic control metrics in a cohort of hospitalized patients with type 1 diabetes using hybrid closed-loop and

Ana María Gómez Medina1, Diana Cristina Henao-Carrillo1, Carlos Yepes1

  • 1Endocrinology Unit, Hospital Universitario San Ignacio, Carrera 7 # 45-62, Colombia; Faculty of Medicine, Pontificia Universidad Javeriana, Carrera 7 # 40-62, Colombia.

Diabetes Research and Clinical Practice
|September 7, 2023
PubMed

Insights

Hybrid closed-loop (HCL) and advanced hybrid closed-loop (AHCL) systems effectively manage glucose levels in hospitalized patients with type 1 diabetes (T1D). These systems achieve over 70% time in range without increasing hypoglycemia, demonstrating their safety and efficacy in a clinical setting.

Area of Science:

  • Endocrinology
  • Medical Devices
  • Diabetes Technology

Background:

  • Hospitalization presents unique glycemic control challenges for individuals with type 1 diabetes (T1D).
  • Continuous glucose monitoring (CGM) metrics are crucial for assessing glycemic control.
  • Hybrid closed-loop (HCL) and advanced hybrid closed-loop (AHCL) systems offer automated insulin delivery.

Purpose of the Study:

  • To evaluate the performance of HCL and AHCL systems in hospitalized T1D patients.
  • To analyze CGM metrics during inpatient stays.
  • To compare the efficacy of Automated Mode (AM) versus SmartGuard (SG) features within these systems.

Main Methods:

  • Observational study of T1D patients using HCL/AHCL with prior hospitalizations.
  • Analysis of CGM data collected during the hospital stay.
  • Sub-analysis comparing patients using AM versus SG during hospitalization or surgical procedures.

Main Results:

  • Seventy-one percent of patients achieved >70% Time in Range (TIR) between 70-180 mg/dL.
  • Overall TIR was 75.5%, with minimal time below range (<70 mg/dL = 2.1%, <54 mg/dL = 0%).
  • AHCL with SG showed a trend towards higher TIR and significantly shorter hospital stays compared to HCL with AM, with no serious adverse events.

Conclusions:

  • HCL/AHCL systems, particularly with active AM/SG, maintain TIR >70% in the 70-180 mg/dL range for T1D patients during hospitalization.
  • These advanced systems improve glycemic control without increasing the risk of hypoglycemia.
  • The findings support the use of HCL/AHCL technology in inpatient settings for T1D management.
Abstract

Keywords:
Automated insulin deliveryHospitalTime in rangeType 1 diabetes

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