A Real-World observational study: Glucose Monitoring Metrics in Type 1 Diabetes using different treatment modalities

24 Aug 2023 • This study aimed to investigate the relationship between continuous glucose monitoring (CGM)-derived glycemic metrics and various insulin treatment methods using real-world data. The cross-sectional study involved individuals with type 1 diabetes using CGM. The data included individuals who used CGM for at least 20% of a 4-week period. Participants were categorized into four groups: multiple daily injection (MDI) therapy, insulin pumps with unintegrated CGM (SUP), sensor-augmented pumps with low glucose management (SAP), and automated insulin delivery (AID). The MDI and SUP groups were further divided based on CGM alarm features. The primary outcome was the percentage of time spent in the target glycemic range (TIR: 3.9–10.0 mmol/L) for each treatment group. Secondary outcomes included other glucose metrics and HbA1c levels. Results from the analysis of 3,184 CGM users revealed that the median TIR was 54.0% for MDI, 54.9% for SUP, 62.9% for SAP, and 72.1% for AID users. The proportion of individuals meeting all recommended glycemic targets (TIR >70%, time above range <25%, and time below range <4%) was significantly higher in SAP (odds ratio [OR]: 2.4 [95% CI: 1.6–3.5]) and AID (OR: 9.4 [95% CI:6.7–13.0]) compared to MDI without alarm features. In conclusion, the study suggests that automated insulin delivery (AID) outperforms other insulin treatment modalities when combined with CGM. Despite potential bias, AID should be considered the preferred option for insulin pump therapy based on the observed results. Source: Diabetes Care | Read full story

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