SFEIES24 Poster Presentations Diabetes & Metabolism (68 abstracts)
Impact of new start hybrid closed loop (HCL) insulin pump therapy on glycaemic control, diabetes distress and hypoglycaemia awareness in tallaght university hospital (TUH)
Mary Horan , Caitlin Thomas , Mary Finn , Rexy George , Celine Kenna , Breda Morris , Ciara O’Brien , Kevin Moore & Ferrah Shaamile
Tallaght University Hospital, Dublin, Ireland
Background: Diabetes nurses and dietitians, with support from the endocrinology team, led a restart of the insulin pump service for pump-naïve patients in TUH in May 2023.
Aim: To compare glycaemic control, diabetes distress and hypoglycaemia awareness pre and post HCL system use in the first 6 months.
Research Design: Patients who had completed BERGER carbohydrate counting course, attended a carbohydrate counting refresher. Food and insulin diaries, HbA1c and retinal screening results were reviewed to ensure safe and accurate HCL system settings. Patients who started HCL therapy (Medtronic 780G pump with Guardian 4 CGM) from May to October 2023 were evaluated using GOLD hypoglycaemia awareness screening tool and Diabetes Distress Scale (DDS-17) or PAID. HbA1c and CGM data were compared.
Results
| Pre | Post | |||||
| n | Mean | SD | n | Mean | SD | |
| HbA1c mmol/mol (%) | 16 | 64.7 (8.1%) | 10.3 | 16 | 56.1 (7.3%) | 6.9 |
| Percentage Time in Range | 18 | 41.7 | 18.1 | 18 | 72.6 | 9.8 |
| Pre | Post | |||
| No. | % | No. | % | |
| Time in Range >70% | 2 | 11.11 | 12 | 66.67 |
| Meeting All CGM Targets* | 1 | 5.56 | 7 | 38.89 |
| Severe Diabetes Distress | 5 | 31.25 | 4 | 25.00 |
| Moderate Diabetes Distress | 8 | 50.00 | 5 | 31.25 |
| No Diabetes Distress | 3 | 18.75 | 7 | 43.75 |
| Impaired Hypoglycaemia Awareness | 6 | 37.50 | 5 | 31.25 |
| Normal Hypoglycaemia Awareness | 9 | 56.25 | 10 | 62.50 |
| Undetermined Hypoglycaemia Awareness | 1 | 6.25 | 1 | 6.25 |
| Pre | Post | |||||
| n | Mean | SD | n | Mean | SD | |
| HbA1c mmol/mol (%) | 16 | 64.7 (8.1%) | 10.3 | 16 | 56.1 (7.3%) | 6.9 |
| Percentage Time in Range | 18 | 41.7 | 18.1 | 18 | 72.6 | 9.8 |
| Pre | Post | |||
| No. | % | No. | % | |
| Time in Range >70% | 2 | 11.11 | 12 | 66.67 |
| Meeting All CGM Targets* | 1 | 5.56 | 7 | 38.89 |
| Severe Diabetes Distress | 5 | 31.25 | 4 | 25.00 |
| Moderate Diabetes Distress | 8 | 50.00 | 5 | 31.25 |
| No Diabetes Distress | 3 | 18.75 | 7 | 43.75 |
| Impaired Hypoglycaemia Awareness | 6 | 37.50 | 5 | 31.25 |
| Normal Hypoglycaemia Awareness | 9 | 56.25 | 10 | 62.50 |
| Undetermined Hypoglycaemia Awareness | 1 | 6.25 | 1 | 6.25 |
Conclusion: Restart of the TUH insulin pump service for pump naïve patients enabled 24 patients to successfully start HCL therapy in this 6 month period. Glycaemic control (HbA1c and time in range), diabetes distress and hypoglycaemia awareness improved.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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