Automated Insulin Delivery in Adults With Type 1 Diabetes and Suboptimal Hemoglobin A1c (HbA1c) During Prior Use of Insulin Pump and Continuous Glucose Monitoring: A Randomized Controlled Trial
Authors' conclusion
For adults with type 1 diabetes not meeting glycemic targets despite use of insulin pump and CGM, transitioning to an AID system confers considerable glycemic benefits.
Study context
- Population
- Adults with T1D and HbA1c ≥ 58 mmol/mol (7.5%) despite insulin pump and continuous glucose monitoring (CGM); mean age 52 ± 11 years, HbA1c 67 ± 7 mmol/mol, diabetes duration 29 ±13 years
- Participants
- 40 adults
- Comparison
- Automated insulin delivery (AID) vs usual care
- Primary endpoint
- Change in TIR (3.9-10.0 mmol/L)
- Follow-up
- Baseline to week 14
Methodological details1:1 allocation, 14-week extension phase (usual care (UC) switched to AID)
- 1:1 allocation
- 14-week extension phase (UC switched to AID)
Primary result
As reported in the abstract
Change in TIR · 14 weeks
AID
18.7%
CI 14.5–22.9%
P < 0.0001
Further findings
| Outcome | AID | P value |
|---|---|---|
| Change in HbA1c · 14 weeksHbA1c decreased with AID, unchanged with UC | 10.0 (CI 7.0, 13.0 mmol/mol) mmol/mol | P < 0.0001 |
| Decrease in % | 0.9% (95% CI 0.6%, 1.2%) |
Change in HbA1c · 14 weeks
- HbA1c remained unchanged in UC
Glycemic benefits after extension phase · 28 weeks
- Glycemic benefits of AID reproduced after the 14-week extension phase
Safety
Severe hypoglycemia or DKA · during the study
- Episodes of severe hypoglycemia or DKA
- 0
Original publication
Automated Insulin Delivery in Adults With Type 1 Diabetes and Suboptimal HbA1c During Prior Use of Insulin Pump and Continuous Glucose Monitoring: A Randomized Controlled Trial. J Diabetes Sci Technol. Published 11 April 2024. doi:10.
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