Switching to advanced hybrid closed-loop system improves detection of hypoglycemia in T1D patients

Written By :  Aditi
Medically Reviewed By :  Dr. Kamal Kant Kohli
Published On 2023-04-13 05:00 GMT   |   Update On 2023-04-13 05:50 GMT
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Spain: An article published in Diabetes Research and Clinical Practice has concluded that switching to an advanced hybrid closed-loop (AHCL) system is associated with the improvement of restoring awareness of hypoglycemia in patients with type 1 diabetes (T1D).

There is a lack of data regarding AHCL system efficacy in improving A1c among patients with an appropriate perception of symptoms of hypoglycemia than those presenting with IAH( impaired awareness of hypoglycemia).

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This was determined by a team of researchers conducting a prospective study on 46 subjects.

They classified the Patients into three groups based on therapy used before switching to Minimed® 780G.

  • Multiple dose insulin (MDI) therapy + FGM, including six patients.
  • Continuous subcutaneous insulin infusion + FGM in 21 patients
  • Sensor-augmented pump with predictive low-glucose suspend in 19 patients.

The study results could be summarised as follows:

  • The mean age of participants was 37 ± 15 years, with a diabetes duration of 20 ± 10 years.
  • Twelve patients constituting 27%, showed IAH as defined by Clarke’s score ≥ 3 at baseline.
  • IAH patients were older with lower estimated glomerular filtration rate (eGFR) than those without IAH having no baseline differences in CGM metrics or A1c.
  • After six months, there was an overall decrease in A1c in the AHCL system from 6.9 ± 0.5% to 6.7 ± 0.6%, regardless of prior insulin therapy.
  • IAH patients showed more significant improvement in metabolic control with a reduction in A1c from 6.9 ± 0.5 to 6.4 ± 0.4% vs 6.9 ± 0.5 to 6.8 ± 0.6%. A parallel increase in total daily insulin boluses and automatic bolus correction administered by the Advanced Hybrid Closed Loop system.
  • After six months, patients with IAH Clarke’s score decreased from 3.6 ± 0.8 (baseline) to 1.9 ± 1.6
  • After six months on the AHCL system, three patients constituting 7%, presented with Clarke’s score ≥ 3 and had an absolute risk reduction of 20% of having IAH.

They wrote, “Switching from any insulin administration to an advanced hybrid closed-loop system improves hypoglycemia awareness and metabolic control in patients with a history of type 1 diabetes, particularly in adults with the impaired perception of hypoglycemia symptoms.

Further reading:

Lía Nattero-Chávez et al., Switching to an advanced hybrid closed-loop system in real-world practice improves hypoglycemia awareness and metabolic control in adults with type 1 diabetes, particularly in those with the impaired perception of hypoglycemia symptoms. https://doi.org/10.1016/j.diabres.2023.110627

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Article Source : Diabetes Research and Clinical Practice

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