Automated Insulin Delivery in Older Adults with Type 1 Diabetes
Authors' conclusion
In older adults with type 1 diabetes, automated insulin delivery decreased hypoglycemia compared with sensor-augmented pump delivery.
Study context
- Population
- Adults aged ≥65 years with T1D; aged 65–86 years, 45% female, baseline mean HbA1c 7.2±0.9%, baseline time <70 mg/dl 2.49±1.78%crossover
- Participants
- 82 adults
- Comparison
- Hybrid closed loop vs predictive low-glucose suspend vs sensor-augmented pump insulin delivery
- Primary endpoint
- Percentage of time with CGM glucose values <70 mg/dl
- Follow-up
- 12-week periods
Methodological detailsmulticenter, three 12-week periods in randomized order
- Multicenter
- Three 12-week periods in randomized order
Primary result
As reported in the abstract
% time with glucose <70 mg/dl
Each group vs sensor-augmented pumpMean difference, percentage points (95% CI)P value
Hybrid closed loop
−1.05(−1.48 to −0.73)
P < 0.001Predictive low-glucose suspend
−0.93(−1.27 to −0.66)
P < 0.001Further findings
| Outcome | Change (percentage points) (95% CI) | |
|---|---|---|
| TIR 70–180 mg/dlBetween Hybrid closed loop and Sensor-augmented pump | 8.9 (7.4–10.4) | |
| −5051015Difference, percentage points (linear scale) |
| Outcome | Change (percentage points) (95% CI) |
|---|---|
| HbA1cBetween Hybrid closed loop and Sensor-augmented pump | 0.2 (−0.3 to −0.1) |
Safety
- Severe hypoglycemia
- 4% or less of participants
- Hospitalizations for DKA
- 2
- Serious adverse events were uncommon
Original publication
Automated Insulin Delivery in Older Adults with Type 1 Diabetes. NEJM Evid. Published 23 December 2024. doi:10.
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