Automated insulin delivery systems in adults with type 1 diabetes: a real game changer?

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F23%3A00084377" target="_blank" >RIV/00023001:_____/23:00084377 - isvavai.cz</a>

Výsledek na webu

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DOI - Digital Object Identifier

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Jazyk výsledku

angličtina

Název v původním jazyce

Automated insulin delivery systems in adults with type 1 diabetes: a real game changer?

Popis výsledku v původním jazyce

Background and aims: Automated insulin delivery (AID) is a diabetes management system that combines an insulin pump (IP) with acontinuous glucose monitoring (CGM) device and an algorithm thatautomatically adjusts insulin delivery based on the CGM readings. Itcan improve glucose control, reduce the risk of hypoglycemia, andimprove the quality of life for people with type 1 diabetes (T1D). Theaim of the study was to compare the efect of AID, IP without AID, andmultiple daily injections (MDI) on glycemic control, risk of hypoglycemia, and its connection with subject characteristics in adults with T1D.Materials and methods: In a cross-sectional study, 1948 adults withT1D (54.7% of men, mean age of 45.7±15.9 years, duration of diabetes 23.5±13.1 years) were enrolled. Subjects were divided into threegroups according to the type of insulin delivery modality used - AID(n=440; 22.6%), IP without AID (n=536; 27.5%), and MDI (n=972;49.9%). CGM has been used in 463 (86.4%) subjects in the IP and in 744subjects (76.4%) in the MDI group. We assessed basic characteristics,glycemic control [HbA1c, time in and below range - TIR (3.9-10), TBR(&lt;3.9)], and the presence of diabetes complications and comorbidities.Results: Subjects using AID had signifcantly better glucose control incomparison with IP and MDI assessed by HbA1c (55.4±10.7 mmol/mol vs60±11.4 and 60±14.5; both p&lt;0.0001; IP vs MDI was NS). The signifcantlybetter efect of AID persisted even in the subanalysis when only patientswith CGM were included in the IP and MDI groups (IP HbA1c 59.5±11.2mmol/mol; MDI 59±13.3; both p&lt;0.0001; IP vs MDI was NS). In addition,there was a longer TIR in AID users (73.4±14.3% vs IP 63.4±16.2%; MDI61.4±18.1%; both p&lt;0.0001; IP vs MDI was p&lt;0.05) and TBR signifcantlyshorter (mean 2.6±3.4% vs IP 4.7±5.4% vs MDI 6.6±6.7%; both p&lt;0.0001;IP vs MDI was p&lt;0.0001). Subjects with AID were signifcantly younger(40±12.3 years vs IP 46.2±15.4 vs MDI 46.2±18.3; both p&lt;0.0001) andhad less complication and comorbidities (31.1% of subjects in AID withoutthem vs IP 17%; p&lt;0.0001 and MDI 27.1%; NS).Conclusion: In our study, subjects with AID had better glucose control and less hypoglycemia in comparison with IP and MDI, whichcould lead to a reduction in the incidence of diabetes complicationsand comorbidities in the long term. AID can become a real gamechanger in the treatment of adults with type 1 diabetes.

Název v anglickém jazyce

Automated insulin delivery systems in adults with type 1 diabetes: a real game changer?

Popis výsledku anglicky

Background and aims: Automated insulin delivery (AID) is a diabetes management system that combines an insulin pump (IP) with acontinuous glucose monitoring (CGM) device and an algorithm thatautomatically adjusts insulin delivery based on the CGM readings. Itcan improve glucose control, reduce the risk of hypoglycemia, andimprove the quality of life for people with type 1 diabetes (T1D). Theaim of the study was to compare the efect of AID, IP without AID, andmultiple daily injections (MDI) on glycemic control, risk of hypoglycemia, and its connection with subject characteristics in adults with T1D.Materials and methods: In a cross-sectional study, 1948 adults withT1D (54.7% of men, mean age of 45.7±15.9 years, duration of diabetes 23.5±13.1 years) were enrolled. Subjects were divided into threegroups according to the type of insulin delivery modality used - AID(n=440; 22.6%), IP without AID (n=536; 27.5%), and MDI (n=972;49.9%). CGM has been used in 463 (86.4%) subjects in the IP and in 744subjects (76.4%) in the MDI group. We assessed basic characteristics,glycemic control [HbA1c, time in and below range - TIR (3.9-10), TBR(&lt;3.9)], and the presence of diabetes complications and comorbidities.Results: Subjects using AID had signifcantly better glucose control incomparison with IP and MDI assessed by HbA1c (55.4±10.7 mmol/mol vs60±11.4 and 60±14.5; both p&lt;0.0001; IP vs MDI was NS). The signifcantlybetter efect of AID persisted even in the subanalysis when only patientswith CGM were included in the IP and MDI groups (IP HbA1c 59.5±11.2mmol/mol; MDI 59±13.3; both p&lt;0.0001; IP vs MDI was NS). In addition,there was a longer TIR in AID users (73.4±14.3% vs IP 63.4±16.2%; MDI61.4±18.1%; both p&lt;0.0001; IP vs MDI was p&lt;0.05) and TBR signifcantlyshorter (mean 2.6±3.4% vs IP 4.7±5.4% vs MDI 6.6±6.7%; both p&lt;0.0001;IP vs MDI was p&lt;0.0001). Subjects with AID were signifcantly younger(40±12.3 years vs IP 46.2±15.4 vs MDI 46.2±18.3; both p&lt;0.0001) andhad less complication and comorbidities (31.1% of subjects in AID withoutthem vs IP 17%; p&lt;0.0001 and MDI 27.1%; NS).Conclusion: In our study, subjects with AID had better glucose control and less hypoglycemia in comparison with IP and MDI, whichcould lead to a reduction in the incidence of diabetes complicationsand comorbidities in the long term. AID can become a real gamechanger in the treatment of adults with type 1 diabetes.

Druh

O - Ostatní výsledky

CEP obor

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OECD FORD obor

30202 - Endocrinology and metabolism (including diabetes, hormones)

Projekt

<a href="/cs/project/LX22NPO5104" target="_blank" >LX22NPO5104: Národní institut pro výzkum metabolických a kardiovaskulárních onemocnění</a><br>

Návaznosti

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Rok uplatnění

2023

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů