Early and sustained increase in time in range 1 year after initiation of hybrid close loop therapy via telemedicine in type 1 diabetes patients

• Published in: Acta diabetologica 2023-07, Vol.60 (7), p.943-949
• Main Authors: Gómez, Ana M., Henao, Diana, Parra, Darío, Kerguelen, Alfonso, Jaramillo, Pablo, Gómez, Yaline, Muñoz, Oscar Mauricio, Rondón, Martin
• Format: Article
• Language: English
• Subjects: Blood Glucose; Blood Glucose Self-Monitoring; Diabetes; Diabetes mellitus (insulin dependent); Diabetes Mellitus, Type 1 - etiology; Humans; Hypoglycemia; Hypoglycemia - chemically induced; Hypoglycemia - etiology; Hypoglycemic Agents - therapeutic use; Insulin - therapeutic use; Insulin Infusion Systems - adverse effects; Internal Medicine; Medicine; Medicine & Public Health; Metabolic Diseases; Original; Original Article; Prospective Studies; Telemedicine
• ISSN: 1432-5233; 0940-5429; 1432-5233
• DOI: 10.1007/s00592-023-02051-w

Background and Aims Evidence supports the efficacy and safety of the Hybrid Close loop (HCL) system in patients with type 1 diabetes (T1D). However, limited data are available on the long-term outcomes of patients on HCL with telemedicine follow-up. Methods A prospective observational cohort study including T1D patients, who were upgrading to HCL system. Virtual training and follow-up were done through telemedicine. CGM data were analyzed to compare the baseline time in range (TIR), time below range (TBR), glycemic variability and auto mode (AM), with measurements performed at 3, 6 and 12 months. Results 134 patients were included with baseline A1c 7.6% ± 1.1. 40.5% had a severe hypoglycemia event in the last year. Baseline TIR, measured two weeks after starting AM was 78.6 ± 9.94%. No changes were evident at three (Mean difference − 0.15;CI-2.47,2.17; p  = 0.96), six (MD-1.09;CI-3.42,1.24; p  = 0.12) and 12 months (MD-1.30;CI-3.64,1.04; p  = 0.08). No significant changes were found in TBR or glycemic variability throughout the follow-up. Use of AM was 85.6 ± 17.5% and percentage of use of sensor was 88.75 ± 9.5% at 12 months. No severe hypoglycemic (SH) events were reported. Conclusions HCL systems allow to improve TIR, TBR and glycemic variability safely, early and sustained up to 1 year of follow-up in patients with T1D and high risk of hypoglycemia followed through telemedicine.