Endocrine Abstracts

Introduction: Achieving glycemic goals remains a challenge for many people with T1D despite recent technological advances. Integrated systems and closed loops pumps have shown significant improvements in glycemic control in clinical studies as well as in real life conditions.

Objective: Assess the performance of the systems Tandem Control-IQ and DIABELOOP in people with T1D comparing the glucosa readings before and after having the device for 14 days.

Research Design and Method: Retrospective observational study of 31 adults with long-evolving T1D, carriers of continuous insulin infusion pump (BICI) for at least 10 years and FSL2 to which a Dexcom G6 sensor is implanted and then the handle is closed. 19 patients (10 women) with a mean age of 49 years, and 29 years of evolution of diabetes were carriers of Tandem Control-IQ system and 12 patients (7 women) with a mean age of 46 years and 28 years of evolution of diabetes, carriers of DIABELOOP system (DBL). Both groups had at least 90% of the time in automatic mode. The data were analyzed by student T for paired samples.

Results: Both groups started from a time under the range (TBR) <54 in objective (IQ control 0.3%; DBL 0.9%) and only the IQ control group started from a TBR<70 in objective of 2%, being 4% in the DBL group. At 14 days, improvement was observed in the rest of the glycometric parameters, being significant in the control group IQ the increase of time in range (TIR, 59.9%-69.63%, P=0.0014), the reduction of average glucose (GM 169.5-156, P=0.0075) and the reduction of the glucose management index (IGG 7.8-%7.1%, P=0.0052). Time above range (ART) 180-250 and > 250 was reduced without reaching statistical significance (ART 30.4%-24.4%, P=0.07; ART>250 11.7%-7.7%, P=0.058. The DBL group showed an increase in IRR (64.2%-70.4%), and a reduction in RRT<70 (4%-1.9%), RRT<54 (0.9%-0.3%), ART (30.1%-23.6%), ART>250 (9.2%-7.2%), LD (159-156 mg/), IGG (7.21%-7.08%) and coefficient of variation, being the only one that reached statistical significance (36.2%-30.6%, P=0.017).

Conclusions: In our sample of patients with long-term T1D who had previously carried BICI and FSL2, loop closure was already associated at 2 weeks with an improvement in most of the glycometric parameters. 100% of patients in the Control IQ group achieve a TBR<54. Despite this, less than 45% of patients have all the parameters in objective, so we recommend an evaluation at 14-30 days after the system is installed for an early optimization of results.