BSPED2022 Poster Presentations Diabetes 3 (8 abstracts)
Use of artificial pancreas systems in routine clinical care is effective in improving glycaemic control in paediatric patients
Abhidhamma Kaninde 1 , Janki Kotak 1 , Louise Collins 1 , Lesley Drummond 1 , John Pemberton 1 , Jan Idkowiak 1,2,3 , Zainaba Mohamed 1,3 , Renuka Dias 1,3 , Vrinda Saraff 1,3 , Melanie Kershaw 1,3 & Ruth Krone 1,3
1Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, United Kingdom; 2Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; 3Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
Introduction: Artificial pancreas systems (APS) have improved glycaemic control in adult and paediatric patients in clinical trials as part of routine clinical care
Aim and objectives: To evaluate the effectiveness of artificial pancreas system in routine clinical care on glycaemic control over a period of three to six months. Changes in glycated haemoglobin (HbA1c), time in range (TIR, 3.9-10 mmol/l) and time below range (TBR, <3.9 mmol/l) were assessed.
Methodology: Retrospective analysis of HbA1c, TIR, TBR in 42 paediatric patients using APS as part of routine clinical care between May 2020 to December 2021. Age group of these patient was 1 to 18 years with median being 11 years. Of 42 patients, 13 patients were on multiple daily injections (MDI) and 29 were on insulin pump before starting on APS. APS used were T slim Control IQ (n=36) and CamAPS FX (n=6). We retrieved patient data from cloud-based storage systems, Dexcom clarity and Diasend, for TIR and TBR, HbA1c was retrieved via electronical case notes. Only patients with minimum of one recorded HbA1c, TIR, TIHR reading pre and post APS were included. Exclusion criteria: transfer of care, use of continuous glucose monitoring less than 70% of total time, lack of data. Out of initial 42 patients using APS, 28 patients were eligible for HbA1C cohort, 35 for TIR cohort and 29 for TBR cohort, based on inclusion and exclusion criteria.
Results: Baseline mean HbA1c was 62.4 mmol/mol (range 51.6-78.3) and improved to 56 mmol/mol (range 49-71.5) at three months and 56.5 mmol/mol (range 48-81) at six months (improvement: -9.45 %; P<0.05). TIR improved from 49.69% (range 14-76) at baseline to 60.60% (range 35-77) at three months and remained at 59.33% (range 33.6-76.1) at 6 months. (Improvement: - TBR at baseline was 2.69% (range 0.6-11.6), 1.91% (range 0-8.3) at three months and 2.15% (range 0.2-8.3) at six months (improvement by 20.7%; P<0.05)
Conclusion: Our data demonstrate that the use of APS in routine clinical care leads to sustained improvement in glycaemic control including children. Further evaluation is required to understand not just the medical, but also the psychological benefits for children and families
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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