Endocrine Abstracts

Aim: To evaluate HbA1c values in patients attending the diabetes service at Galway University Hospital before and after initiating hybrid closed loop pump therapy.

Background: Advancements in the treatment of Type 1 diabetes mellitus, especially the development of hybrid closed loop pump systems, have greatly improved blood glucose management. These systems automate insulin delivery based on real-time glucose readings, enhancing glycaemic control, and alleviating the self-management burden for patients. Consequently, an increasing number of patients are starting on hybrid closed loop pump therapy.

Methods: We reviewed our patient cohort who began hybrid closed loop pump therapy, including within the last three years, assessing their HbA1c levels both before initiation and at least three months post-therapy. This allowed us to evaluate the impact of the pump on long-term glycaemic control.

Results: We analysed 278 patients: 225 using Medtronic 780G, 49 with the Tandem T-slim X2, and 4 with the Ypsomed Cam APS. Among these patients, 144 exhibited improvements in their HbA1c levels with improvements ranging from a minimum of 2.9% to a maximum of 48%. 87 patients either had no HbA1c data post pump therapy or had been on pump therapy for only 1-2 months. The remaining 48 patients experienced no change or a deterioration in their HbA1c levels following the initiation of pump therapy.

Conclusion: This audit demonstrates that the majority of patients experienced an improvement in HbA1c levels following the initiation of hybrid closed-loop therapy. Cases where HbA1c levels remained unchanged or worsened were mainly attributable to technical issues or user errors. Overall, the findings suggest that hybrid closed-loop therapy is associated with enhanced glycaemic management in patients with type 1 diabetes mellitus.