Prolonged Use of an Automated Insulin Delivery System Improves Sleep in Long-Standing Type 1 Diabetes Complicated by Impaired Awareness of Hypoglycemia
Authors' conclusion
AID improved sleep initiation and maintenance. Improved awareness of hypoglycemia, reduced hypoglycemia severity, hypoglycemia exposure, and glucose variability preceded sleep improvements.This trial is
Study context
- Population
- Adults with long-standing T1D and impaired awareness of hypoglycemia (IAH); median age 58 years8 analysed
- Participants
- 10 adults
- Comparison
- 18 months after automated insulin delivery (AID) initiation vs baseline
- AIDn = 8
Methodological details18-month, actigraphy and continuous glucose monitoring (CGM), pre-post
- 18-month
- Actigraphy and CGM
- Pre-post
Primary result
As reported in the abstract
Actigraphy-estimated sleep, baseline to 18 months
- Shorter sleep latency
- P < .05, d = 1.74
- Later sleep offset
- P < .05, d = 0.90
- Less wake after sleep onset
- P < .01, d = 1.43
- Later sleep onset (medium effect size)
- d = 0.74
- Later sleep midpoint (medium effect size)
- d = 0.77
Further findings
Hypoglycemia awareness, severity, exposure and glucose variability (preceding sleep improvements)
- Improved hypoglycemia awareness (Clarke score)
- d = 1.18
- Reduced hypoglycemia severity (HYPO score)
- d = 2.13
- Reduced sleep-associated hypoglycemia (% time <54, <60, <70 mg/dL)
- d = 0.66-0.81
- Reduced glucose variability, lability index
- d = 0.86
- Reduced glucose variability, CGM CV
- d = 0.62
Original publication
Prolonged Use of an Automated Insulin Delivery System Improves Sleep in Long-Standing Type 1 Diabetes Complicated by Impaired Awareness of Hypoglycemia. J Diabetes Sci Technol. Published 14 July 2023. doi:10.
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