Clinical and metabolic outcomes of artificial pancreas systems in patients with type 1 diabetes: A real-world study

Artificial pancreas systems represent an important technological advancement in the management of type 1 diabetes mellitus (T1DM). These systems provide automated insulin delivery and have the potential to improve glycemic control and cardiometabolic outcomes. In this study, we aimed to evaluate the effects of artificial pancreas systems on glycemic control, lipid parameters, and proteinuria in patients with T1DM in a real-world clinical setting.

This retrospective study included 32 patients with T1DM who transitioned to artificial pancreas therapy. Glycemic parameters including HbA1c, fasting blood glucose (FBG), and postprandial blood glucose (PBG) were compared before pump initiation and at 3 months, 6 months, and 1 year after treatment. Lipid parameters and spot urine proteinuria levels were evaluated before pump therapy and at 1-year follow-up. Repeated measures ANOVA and paired t-tests were used for continuous variables, while Cochran's Q and McNemar tests were used for categorical variables.

A significant reduction in HbA1c levels was observed over time, decreasing from 8.74 ± 1.21% before pump initiation to 7.92 ± 0.98% at 3 months, 7.61 ± 0.87% at 6 months, and 7.48 ± 0.83% at 1 year (p < 0.001). Fasting and postprandial glucose levels also significantly declined during follow-up (p < 0.001). LDL cholesterol and total cholesterol levels decreased significantly at 1 year (p = 0.029 and p = 0.006, respectively), while HDL cholesterol increased significantly (p = 0.022). The reduction in triglyceride levels was not statistically significant (p = 0.069). Proteinuria levels decreased from 84.6 ± 42.3 mg/g before pump therapy to 61.8 ± 35.7 mg/g at 1 year (p = 0.011). The proportion of patients achieving HbA1c target increased from 18.8% before pump therapy to 62.5% at 1 year (p < 0.001).

Artificial pancreas therapy significantly improves glycemic control and increases the proportion of patients achieving HbA1c targets in individuals with T1DM. In addition, favorable effects on lipid profile and proteinuria suggest potential cardiometabolic benefits of artificial pancreas systems.