Endocrine Abstracts

Introduction: In the past few years, advances in technology applied to diabetes have significantly changed the type 1 diabetes management. However, only a minority of patients with type 1 diabetes achieves the recommended glycemic goals. Advanced Hybrid Closed-Loop (AHCL) systems, which combine continuous glucose monitoring (CGM) with a continuous subcutaneous insulin infusion (CSII) pump and a control algorithm, improve glycemic control and patient-reported outcomes, such as satisfaction.

Objectives: To evaluate the glycemic control in real life with the different AHCL systems, as well as the differences between them and the degree of patient satisfaction with the treatment.

Material and methods: A prospective observational study was carried out with adults with type 1 diabetes who started treatment with an AHCL system at our Hospital. Data on glycemic control were collected, in terms of HbA1c and CGM glucometric parameters, as well as data related to treatment satisfaction at baseline and at 6 months. In addition, glucometric parameters were also collected one month after the start of therapy.

Results: A total of 40 patients were included (27 started Minimed 780G, 6 Tandem Control-IQ and 7 DIABELOOP DBLG1 patients). They had a mean age of 39.9±14.3 years, the majority were women (67.5%), with a mean duration of diabetes of 26.9±12.4 years. In the total cohort, after 6 months of treatment, HbA1c was reduced from 7.26±0.91% to 6.98±0.76% (P=0.002), as well as the TIR increased from 65 (IQR 56 -71) % to 77.5 (IQR 71-85) % (P=0.0003). It was observed that a TIR of 75 (72-84) % was reached one month after starting treatment (P<0.0001). The percentage of patients who achieved optimal control after therapy increased from 17.5% to 75% (P<0.0001). At 6 months after the start of therapy, no significant differences in glycemic control were observed between the systems, however, Minimed 780G was the only system that improved HbA1c (from 7.35±0.91 to 7.07±0.84) (P=0.03) as well as the TIR (65 (IQR 56-71) to 79.5 (IQR 71-82.25) (P<0.0001). According to the DTSQ-c and DTSQ-s, the change of treatment to an AHCL system was satisfactory and there was a significant improvement in satisfaction after 6 months of therapy (P<0.0001), with no significant differences between the different systems.

Conclusion: After 6 months of treatment with AHCL systems, significant improvements were observed, both in glycemic results and those related to patient satisfaction, with no between-group differences.