Impact of Technology Introduction on Glycemic Control of People Living with Type 1 Diabetes in Belgium: An Observational, Real-World Study
Authors' conclusion
Over 14 years, glycemic and lipid outcomes improved alongside near-universal CGM use and increasing adoption of HCL therapy.
Study context
- Population
- People living with T1D in a nationwide structured care program in Belgium with full reimbursement of diabetes technologies; adults and children/adolescents
- Exposure
- Audit periods 2010-2011 vs 2023-2024; Hybrid closed-loop (HCL) vs other technology modalities in 2023-2024
- Outcome
- Long-term trends in metabolic outcomes: HbA1c, low-density lipoprotein (LDL) cholesterol, SBP and BMI
Methodological detailsobservational, real-world, nationwide structured care program, three audit periods (2010-2011, 2017-2018, 2023-2024), generalized estimating equations adjusted for age, sex, diabetes duration, insulin delivery and glucose monitoring modalities
- Observational
- Real-world
- Nationwide structured care program
- Three audit periods (2010-2011, 2017-2018, 2023-2024)
- Generalized estimating equations adjusted for age, sex, diabetes duration, insulin delivery and glucose monitoring modalities
Main finding
As reported in the abstract
Adults: HbA1c decreased
from 7.9% (62.8 mmol/mol) to 7.5% (58.5 mmol/mol)
P < 0.001
Observational data: associations, not effects.
Further findings
HbA1c target attainment (<7%; <53 mmol/mol), adults · 2010-2011 to 2023-2024
- Adults: target attainment increased
- from 22.3% to 35.1%
HbA1c, children and adolescents · 2010-2011 to 2023-2024
- Children and adolescents: HbA1c declined
- from 8.0% (63.5 mmol/mol) to 7.6% (59.0 mmol/mol, P < 0.01)
HbA1c target attainment, children and adolescents · 2010-2011 to 2023-2024
- Children and adolescents: target attainment rose
- from 19.7% to 33.1% (P < 0.001)
Technology use · 2023-2024
- Continuous glucose monitoring (CGM) use
- exceeded 90%
- Insulin pump use, adults
- 25%
- Insulin pump use, younger individuals
- 47%
Glycaemic outcomes with HCL vs other modalities, adults · 2023-2024
- HCL: lower HbA1c vs other modalities (P < 0.001)
- 7.0%; 53.5 mmol/mol
- HCL: higher TIR vs other modalities (P < 0.001)
- 73%
- HCL: lower TBR vs other modalities (P < 0.001)
- 1.5%
LDL-C target attainment (<70 mg/dL; <1.8 mmol/L) · 2010-2011 to 2023-2024
- LDL-C target attainment increased
- from 18.3% to 37.4% (P < 0.001)
LDL-C target attainment in those with CVD (<55 mg/dL; <1.4 mmol/L) · 2010-2011 to 2023-2024
- CVD: LDL-C target attainment increased
- from 15.5% to 46.5% (P < 0.001)
Systolic blood pressure and obesity
- Systolic blood pressure (SBP) remained stable
- Obesity prevalence increased in all age groups
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →