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Switching to automated insulin delivery (AID) therapy significantly improved glycemic control in individuals with type 1 diabetes (T1D). More patients achieved target glucose levels, reducing instances of poor glycemic control.

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Area of Science:

  • Endocrinology and Metabolism
  • Diabetes Technology
  • Public Health and Quality Measures

Background:

  • Type 1 diabetes (T1D) management often involves multiple daily insulin injections (MDI).
  • Automated insulin delivery (AID) systems offer advanced glycemic control solutions.
  • Healthcare Effectiveness Data and Information Set (HEDIS) measures assess glycemic status using HbA1c and glucose management indicator (GMI).

Purpose of the Study:

  • To evaluate the impact of switching from MDI to Control-IQ AID on glycemic control in T1D.
  • To assess changes in glucose management indicator (GMI) and hemoglobin A1c (HbA1c) at 12 months post-transition.
  • To compare achievement of HEDIS and American Diabetes Association (ADA) glycemic targets across different payer types.

Main Methods:

  • Retrospective analysis of US-based data from 12,522 individuals with T1D.
  • Inclusion criteria: prior MDI use, ≥1 year on Control-IQ, baseline HbA1c within 6 months of initiation, and ≥70% continuous glucose monitoring use.
  • Primary outcome: change in proportion meeting HEDIS (<8% HbA1c/GMI) and ADA (<7% GMI) targets, analyzed by payer (commercial, Medicaid, Medicare).

Main Results:

  • Significant improvement in meeting HEDIS quality standards, increasing from 49.6% to 92.9% at 12 months post-AID initiation.
  • Similar improvements observed for those achieving <7% GMI.
  • Dramatic reduction in poor glycemic control (HbA1c >9%), decreasing from 3431 to 15 individuals (a 99.6% decrease) across all payer groups.

Conclusions:

  • Control-IQ AID therapy enables a substantially higher proportion of individuals with T1D to achieve glycemic targets compared to MDI.
  • Improved glycemic control was consistent across commercial, Medicaid, and Medicare payer groups.
  • AID technology represents a significant advancement in achieving optimal glycemic status for individuals with T1D.