Hybrid Closed-Loop Therapy in Adults With Type 1 Diabetes and Above-Target HbA1c: A Real-world Observational Study
Authors' conclusion
Use of HCL is associated with improvements in HbA1c, time in range, hypoglycemia, and diabetes-related distress and quality of life in people with type 1 diabetes in the real world.
Study context
- Population
- Adults with T1D using intermittently scanned continuous glucose monitoring (isCGM) and insulin pump with HbA1c ≥8.5%, NHS England closed-loop pilot, 31 centers; median age 40 (IQR 29–50) years, 67% female, 85% White520 continuing hybrid closed-loop (HCL)
- Participants
- 570 adults
- Exposure
- HCL therapy: follow-up vs baseline
- HCLn = 570
- Outcome
- Change in HbA1c
- Follow-up
- Median 5.1 (IQR 3.9-6.6) months
Methodological detailspragmatic, preplanned, multicentre (31 diabetes centers), real-world
- Pragmatic
- Preplanned
- Multicentre (31 diabetes centers)
- Real-world
Main finding
As reported in the abstract
median follow-up 5.1 months
HCL
9.4
mean · ± 0.9 · % (baseline)
- Mean adjusted HbA1c reduction, %
- 1.7% (95% CI 1.5, 1.8; P < 0.0001)
- Mean adjusted HbA1c reduction, mmol/mol
- 18.1 mmol/mol (95% CI 16.6, 19.6; P < 0.0001)
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Positive impact of HCL on quality of life (user rating) | HCL 94.7% |
TIR (70-180 mg/dL) · baseline to follow-up
- TIR increased from 34.2 to 61.9% (P < 0.001)
HbA1c ≤58 mmol/mol · baseline to follow-up
- Proportion rose from 0 to 39.4% (P < 0.0001)
TIR ≥70% and TBR <4% · baseline to follow-up
- Proportion increased from 0.8 to 28.2% (P < 0.0001)
Original publication
Hybrid Closed-Loop Therapy in Adults With Type 1 Diabetes and Above-Target HbA1c: A Real-world Observational Study. Diabetes Care. Published 11 August 2023. doi:10.
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