Changes in ambulatory glucose profile in people with type 1 diabetes using an automated insulin delivery system - two year follow-up retrospective analysis of real-world data
The number of available automated insulin delivery (AID) systems is increasing in Austria and people with diabetes (PwD) replace sensor-augmented pump (SAP) therapy more and more frequently. The present study is the two years follow-up of our prior monocentric, retrospective analysis conducted betwe...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-07-01
|
| Series: | Diabetes Epidemiology and Management |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666970623000227 |
| _version_ | 1827889864558772224 |
|---|---|
| author | Michael Müller-Korbsch Antonia Kietaibl Yves Haufe Peter Fasching |
| author_facet | Michael Müller-Korbsch Antonia Kietaibl Yves Haufe Peter Fasching |
| author_sort | Michael Müller-Korbsch |
| collection | DOAJ |
| description | The number of available automated insulin delivery (AID) systems is increasing in Austria and people with diabetes (PwD) replace sensor-augmented pump (SAP) therapy more and more frequently. The present study is the two years follow-up of our prior monocentric, retrospective analysis conducted between 2019 and 2021, comparing SAP and open-source AID systems in people with type 1 diabetes. This second-year analysis included 25 PwD and investigated glycemic changes based on ambulatory glucose profiles (AGP). In comparison to the first year, a worsening of mean glucose (125.4 to 135.2 mg/dl, P = 0.038), time in range ((TIR), 84.2 to 77.0%, P = 0.012), time above range ((TAR), 11.6% to 18.5%, P = 0.017) and glycemia risk index ((GRI), 24.8 to 35.0%, P = 0.026) was observed. The reduction of mean glucose and glucose variability with AID in the first year was due to a significant decrease in time in hyperglycemia with resulting higher TIR and lower GRI. In this second-year follow up, TIR and GRI showed a significant deterioration, a familiar phenomenon in diabetology. However, open-source AID systems showed continuous safety, as there was no increase in time below range (TBR) even after two years. Despite the slight deterioration in the glycemic parameters, open-source AID systems were able to demonstrate sufficient glycemic control according to international consensus guidelines while offering the characteristic benefits of a reduced burden of diabetes management. A descriptive comparison of different AID algorithms indicated an improved glycemic control with more advanced features such as basal rate modification, auto bolus function and autotuning. |
| first_indexed | 2024-03-12T21:01:45Z |
| format | Article |
| id | doaj.art-2f8c32c23c11492283510197c5b5d0f3 |
| institution | Directory Open Access Journal |
| issn | 2666-9706 |
| language | English |
| last_indexed | 2024-03-12T21:01:45Z |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Diabetes Epidemiology and Management |
| spelling | doaj.art-2f8c32c23c11492283510197c5b5d0f32023-07-31T04:09:28ZengElsevierDiabetes Epidemiology and Management2666-97062023-07-0111100150Changes in ambulatory glucose profile in people with type 1 diabetes using an automated insulin delivery system - two year follow-up retrospective analysis of real-world dataMichael Müller-Korbsch0Antonia Kietaibl1Yves Haufe2Peter Fasching3MedVienna Ärztezentrum, Sensengasse 3/1/1-3, Vienna 1090, Austria; Corresponding author.5th Medical Department, Clinic Ottakring, Vienna, AustriaDexcom Deutschland GmbH, Mainz, Germany5th Medical Department, Clinic Ottakring, Vienna, AustriaThe number of available automated insulin delivery (AID) systems is increasing in Austria and people with diabetes (PwD) replace sensor-augmented pump (SAP) therapy more and more frequently. The present study is the two years follow-up of our prior monocentric, retrospective analysis conducted between 2019 and 2021, comparing SAP and open-source AID systems in people with type 1 diabetes. This second-year analysis included 25 PwD and investigated glycemic changes based on ambulatory glucose profiles (AGP). In comparison to the first year, a worsening of mean glucose (125.4 to 135.2 mg/dl, P = 0.038), time in range ((TIR), 84.2 to 77.0%, P = 0.012), time above range ((TAR), 11.6% to 18.5%, P = 0.017) and glycemia risk index ((GRI), 24.8 to 35.0%, P = 0.026) was observed. The reduction of mean glucose and glucose variability with AID in the first year was due to a significant decrease in time in hyperglycemia with resulting higher TIR and lower GRI. In this second-year follow up, TIR and GRI showed a significant deterioration, a familiar phenomenon in diabetology. However, open-source AID systems showed continuous safety, as there was no increase in time below range (TBR) even after two years. Despite the slight deterioration in the glycemic parameters, open-source AID systems were able to demonstrate sufficient glycemic control according to international consensus guidelines while offering the characteristic benefits of a reduced burden of diabetes management. A descriptive comparison of different AID algorithms indicated an improved glycemic control with more advanced features such as basal rate modification, auto bolus function and autotuning.http://www.sciencedirect.com/science/article/pii/S2666970623000227Automated insulin deliveryDiabetes mellitus type 1Diabetes technologyOpen-source AID |
| spellingShingle | Michael Müller-Korbsch Antonia Kietaibl Yves Haufe Peter Fasching Changes in ambulatory glucose profile in people with type 1 diabetes using an automated insulin delivery system - two year follow-up retrospective analysis of real-world data Diabetes Epidemiology and Management Automated insulin delivery Diabetes mellitus type 1 Diabetes technology Open-source AID |
| title | Changes in ambulatory glucose profile in people with type 1 diabetes using an automated insulin delivery system - two year follow-up retrospective analysis of real-world data |
| title_full | Changes in ambulatory glucose profile in people with type 1 diabetes using an automated insulin delivery system - two year follow-up retrospective analysis of real-world data |
| title_fullStr | Changes in ambulatory glucose profile in people with type 1 diabetes using an automated insulin delivery system - two year follow-up retrospective analysis of real-world data |
| title_full_unstemmed | Changes in ambulatory glucose profile in people with type 1 diabetes using an automated insulin delivery system - two year follow-up retrospective analysis of real-world data |
| title_short | Changes in ambulatory glucose profile in people with type 1 diabetes using an automated insulin delivery system - two year follow-up retrospective analysis of real-world data |
| title_sort | changes in ambulatory glucose profile in people with type 1 diabetes using an automated insulin delivery system two year follow up retrospective analysis of real world data |
| topic | Automated insulin delivery Diabetes mellitus type 1 Diabetes technology Open-source AID |
| url | http://www.sciencedirect.com/science/article/pii/S2666970623000227 |
| work_keys_str_mv | AT michaelmullerkorbsch changesinambulatoryglucoseprofileinpeoplewithtype1diabetesusinganautomatedinsulindeliverysystemtwoyearfollowupretrospectiveanalysisofrealworlddata AT antoniakietaibl changesinambulatoryglucoseprofileinpeoplewithtype1diabetesusinganautomatedinsulindeliverysystemtwoyearfollowupretrospectiveanalysisofrealworlddata AT yveshaufe changesinambulatoryglucoseprofileinpeoplewithtype1diabetesusinganautomatedinsulindeliverysystemtwoyearfollowupretrospectiveanalysisofrealworlddata AT peterfasching changesinambulatoryglucoseprofileinpeoplewithtype1diabetesusinganautomatedinsulindeliverysystemtwoyearfollowupretrospectiveanalysisofrealworlddata |