Automated insulin delivery systems in elderly patients with brittle type 2 diabetes
Authors' conclusion
Although AID systems are tested mostly in young type 1 patients our results show that elderly patients with brittle type 2 diabetes also benefit from an AID system. Even in very frail patients such as cancer patients, improvement can be seen.
Study context
- Population
- Patients ≥60 years with brittle T2D, including cancer patients, switched from multiple-dose insulin (MDI) to Automated Insulin Delivery (AID); median age 67 (IQR 63.0–75.5), 14 male (41.2 %); 6 (17.6 %) on chemotherapy and/or steroids
- Participants
- 34 patients
- Exposure
- AID system vs prior MDI
- AIDn = 34
- Outcome
- HbA1c %
- Follow-up
- 6 months after switch to AID
Methodological detailsFollow-up of HbA1c, weight, total daily insulin, C-peptide, creatinine and lipids for at least six months
- Follow-up of HbA1c, weight, total daily insulin, C-peptide, creatinine and lipids for at least six months
Main finding
As reported in the abstract
Initial median HbA1c %
9.3
IQR 7.6–11.0
HbA1c % 6 months after switch to AID
7.1
IQR 6.5–8.1p < 0.001
Observational data: associations, not effects.
Further findings
C-peptide · 6 months after switch to AID
- Initial c-peptide level
- 0.9 (IQR 0.5-2.2) ng/mL
- C-peptide 6 months after switch to AID
- 1.21 (IQR 0.2-1.7) ng/mL, p = 0.878
Total daily insulin dose · 6 months after switch to AID
- Initial median total daily insulin dose
- 41 IU (IQR 32-53)
- Total insulin dose decreased with AID
- 32 IU (IQR 23.9-37.8), p < 0.001
Median HbA1c % in patients on chemotherapy and/or steroids (Ch/S)
- Decrease in median HbA1c %, not statistically significant
- 8.7 (IQR 7.0-11.5) to 6.9 (IQR 6.3-9.2), p = 0.225
- Ch/S subgroup: 6 patients (17.6 %)
Total insulin dose in patients on Ch/S
- Decrease without statistical significance
- 33 IU (IQR 41-28) to 28 (IQR 23-35), p = 0.173
Mean time in range (TIR) percent with AID systems
%
- <54 mg/dL
- 0.5
- 56-70 mg/dL
- 1.3
- 70-180 mg/dL
- 64.8
- >180 mg/dL
- 26.7
- > 250 mg/dL
- 6.7
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →