Switching from predictive low glucose suspend to advanced hybrid closed loop control: Effects on glucose control and patient reported outcomes

• Published in: Diabetes research and clinical practice Vol. 185; p. 109784
• Main Authors: Boscari, Federico, Ferretto, Sara, Cavallin, Francesco, Bruttomesso, Daniela
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.03.2022
• Subjects: Advanced hybrid closed loop control; Glucose control; Predictive low glucose suspend; Psychological aspects; Time in range; Type 1 diabetes; Psychological aspects; Predictive low glucose suspend; Type 1 diabetes; Advanced hybrid closed loop control; Glucose control; Time in range
• ISSN: 0168-8227; 1872-8227; 1872-8227
• DOI: 10.1016/j.diabres.2022.109784

•Advanced Hybrid Closed Loop (AHCL) improves glucose control in diabetes.•AHCL ameliorates glucose control compared to predictive low glucose suspend (PLGS).•AHCL reduces fear of hypoglycemia compared to PLGS.•Compared to PLGS, AHCL increases patient satisfaction regarding therapy. Automated insulin delivery improves glucose control. Aim of this study was to compare in real life the effects on glucose control and patient reported outcomes of an advanced hybrid closed loop system (Control-IQ), versus a simpler system with predictive low glucose suspend function (Basal-IQ). Thirty-one type 1 diabetic subjects were studied during Basal-IQ and after switching to Control-IQ. Variables analyzed were time spent in range (70–180 mg/dL), in tight range (70–140 mg/dL), above range (>180 mg/dL), below range (<70 mg/dL), mean glucose, coefficient of variation and glycated hemoglobin. Questionnaires were administered regarding therapy satisfaction (Diabetes Treatment Satisfaction Questionnaire in status/change form), fear of hypoglycemia (Hypoglycemia Fear Survey), quality of sleep (Pittsburgh Sleep Quality Index). After 12 weeks of Control-IQ, time in range increased from 62.7 to 74.0%, p < 0.0001, time in tight range increased from 37.1 to 44.6 %, p < 0.001, time above range decreased from 35.6 to 24.4% p < 0.0001. Improvements were observed in mean glucose and glucose variability. Glycated hemoglobin decreased from 7.0% (53 mmol/mol) to 6.6% (49 mmol/mol), p < 0.0001. Subjects using Control-IQ manifested greater satisfaction and less fear of hypoglycemia. Compared to Basal-IQ, Control-IQ improves glucose control and therapy satisfaction.