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  • Automated insulin...

Automated insulin delivery improves TIR in hospitalized type 1 diabetes patients without increasing hypoglycemia

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 3 Oct 2023 5:15 AM  |  Updated On 3 Oct 2023 6:38 AM
Automated insulin delivery improves TIR in hospitalized type 1 diabetes patients without increasing hypoglycemia
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Carrera: HCL/AHCL systems with the Automated Mode/SmartGuard feature in patients with type 1 diabetes (T1D) in the hospital environment lead to improved time in range without increasing hypoglycemia, a recent study published in Diabetes Research and Clinical Practice has revealed.

Ana María Gómez Medina and colleagues sought to describe the performance of hybrid closed-loop (HCL) and advanced hybrid closed-loop (AHCL) in the hospital setting based on the continuous glucose monitoring (CGM) metrics description. They revealed that HCL/AHCL systems with active AM/SG in T1D patients in the hospital environment lead to %TIR>70% in ranges of 70–180 mg/dL in patients without an increased hypoglycemia incidence.

The researchers note minimal evidence of the use of hybrid closed-loop/advanced hybrid closed-loop systems for inpatient management. Current guidelines do not include specific recommendations regarding HCL/AHCL systems in the hospital.

The investigators conducted an observational study from a cohort of patients with type 1 diabetes using HCL/AHCL with a history of hospitalization. During the hospital stay, CGM metrics were analyzed. They also performed a CGM metrics sub-analysis of the population with active Automated Mode and SmartGuard during hospitalization and/or surgical procedures. Twenty-four patients were included (50% women; mean age, 49 years).

The researchers reported the following findings:

  • During hospitalization, 70.8% of patients achieved a time in Range (TIR) between 70–180 mg/dL≥70%.
  • The overall %TIR was 75.5%, the % time below range (TBR)<70 mg/dL was 2.1% and the %TBR<54 mg/dL was 0%.
  • Users of the AHCL with active SG achieved a non-significant higher %TIR during hospitalization (79% versus 76%) and had a shorter stay (3 versus 6 days) compared to the users of the HCL with AM active.
  • No device-related serious adverse events occurred for users of either system.

Noting a little evidence about using HCL and AHCL systems in a hospital setting, the researchers add that the study shows that the use of this technology in type 1 diabetes patients in a real-life hospital environment maintained the %TIR between 70 and 180 mg/dL without increasing hypoglycemia both in the general ward and during surgical procedures.

Additionally, AHCL use with active SG was linked with a higher %TIR without increasing hypoglycemia and a shorter hospital stay compared to the use of HCL with active AM.

"However, there is a need for further studies to determine whether the use of this technology can impact outcomes such as hospital stay, mortality, and morbidity among hospitalized patients," they concluded.

Reference:

María Gómez Medina A, Cristina Henao-Carrillo D, Yepes C, Silva J, Alberto Gómez González J, Cortes D, Robledo S, Mejía G, Rondon M. Glycemic control metrics in a cohort of hospitalized patients with type 1 diabetes using hybrid closed-loop and advanced hybrid closed-loop systems. Diabetes Res Clin Pract. 2023 Sep 5:110897. doi: 10.1016/j.diabres.2023.110897. Epub ahead of print. PMID: 37678728.


Diabetes Research and Clinical Practiceautomated insulin deliverytime in rangetype 1 diabetesglycemic control
Source : Diabetes Research and Clinical Practice
Medha Baranwal
Medha Baranwal

    MSc. Biotechnology

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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