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

• 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