Related Experiment Video
Updated: Sep 8, 2025

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Evaluation of Glycemia Risk Index and Continuous Glucose Monitoring Outcomes Following the Transition to an Advanced
Ayman Al Hayek1, Wael M Alzahrani2, Abdulghani H Al Saeed2
1Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, P.O. Box 7897, 11159, Riyadh, Saudi Arabia. ayman.alhayek@yahoo.com.
Introduction:
Advanced hybrid closed-loop (AHCL) systems have shown promise in improving glycemic control in adults with type 1 diabetes (T1D), yet real-world evidence remains limited. This study evaluated the impact of transitioning from multiple daily injections (MDI) or conventional continuous subcutaneous insulin infusion (CSII) to the Tandem t:slim X2™ Control-IQ® AHCL system on glycemic outcomes in adults with T1D.
Methods:
In this retrospective study, 56 non-pregnant adults with T1D were followed for 6 months. Primary outcomes were changes in the Glycemia Risk Index (GRI) and percentage time in the tight range (%TiTR70-140). Secondary outcomes included other standardized ambulatory glucose profile metrics as well as additional glycemic, anthropometric, and insulin dosing measures.
Results:
Transition to the Control-IQ system increased %TiTR70-140 by 11.5 percentage points and reduced GRI by 23.5 points. Both components of the GRI, hypoglycemia risk (%Chypo) and hyperglycemia risk (%Chyper), improved significantly. Hemoglobin A1c decreased by 1.0%, time in range (%TIR70-180) improved by 13.6 percentage points, and glycemic variability (CV%) showed marked improvement. Total daily insulin dose decreased by 34%, accompanied by modest weight loss. No diabetic ketoacidosis episodes were reported throughout the study period.
Conclusion:
Transitioning to the Tandem t:slim X2 Control-IQ AHCL system led to significant improvements in tight glycemic control, glycemic risk reduction, and insulin efficiency, with a favorable safety profile. These findings support broader adoption of AHCL technology and underscore the need for prospective multicenter studies.
Related Concept Videos
Diabetes Mellitus: Type 2 and Gestational
Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Diabetes: Symptoms, Diagnosis, and Complications
Hypoglycemia and Glucagon
Insulin: Dosing Regimen and Adverse Effects
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...

