Massive switch to an automated insulin delivery system in adults with type 1 diabetes previously treated with sensor-augmented pump due to high risk for hypoglycemia

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion Pub Date : 2024-11-01 DOI:10.1016/j.endien.2024.11.004

Alex Mesa , Daria Roca , Montse Granados , Irene Pueyo , Carla Cabré , Antonio J. Amor , Clara Solà , Olga Matas , Júlia Castanys , Ignacio Conget , Marga Giménez

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引用次数: 0

Abstract

Introduction

Automatic insulin delivery (AID) systems improve glycemic control and quality of life in individuals with type 1 diabetes (T1D). Our aim was to assess the feasibility, effectiveness, and safety of switching from a sensor-augmented pump (SAP) to AID in T1D subjects at high risk of hypoglycemia.

Materials and methods

A manufacturer-led program consisting of three sessions was implemented. Over three days, all patients completed the first session in-person, in groups of 6–12 people, to receive device training. Subsequently, the automatic mode was activated virtually (session 2), followed by online data download (session 3). Glucometric outcomes were evaluated after one month, along with serious adverse events (SAEs), technical incidents, and perceived satisfaction.

Results

The switch was performed in 125 patients, 56.8% of whom were women, with a mean age of 44.1 ± 14.9 years. 99.2% (n = 124) initialized auto-mode. There was an increase in time in range 70–180 mg/dL (64.3 ± 11.3 vs. 74.7 ± 11.2; p < 0.001) and a decrease in time below 70 mg/dL (4.1 ± 3.9 vs. 2.0 ± 1.8; p < 0.001) (N = 97). Forty-one related calls were received, with 10 requiring in-person visits. Medtronic technical service handled 92 related calls (0.74 per patient), from 47 different users (37.6%). One event of severe hypoglycemia was recorded as an SAE. Perceived security and satisfaction with the switch process were high in 91% and 92% of patients, respectively.

Conclusions

Massive switch from SAP to AID in T1D patients at high risk of hypoglycemia is feasible and safe through a hybrid program conducted in collaboration with the manufacturer.

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由于低血糖风险高，之前使用传感器增强泵治疗的 1 型糖尿病成人患者大规模改用胰岛素自动给药系统。

导言：胰岛素自动给药系统（AID）可改善 1 型糖尿病（T1D）患者的血糖控制和生活质量。我们的目的是评估在低血糖风险较高的 1 型糖尿病患者中从传感器增强泵（SAP）转向 AID 的可行性、有效性和安全性：实施了一项由制造商主导的计划，该计划包括三个环节。在三天的时间里，所有患者以 6-12 人为一组，亲自参加了第一次培训，接受设备培训。随后，通过虚拟方式启动自动模式（第二部分），再进行在线数据下载（第三部分）。一个月后，对血糖结果、严重不良事件（SAE）、技术事故和满意度进行了评估：125名患者进行了切换，其中56.8%为女性，平均年龄（44.1 ± 14.9）岁。99.2%（n = 124）的患者初始化了自动模式。在 70-180 mg/dL 范围内的时间增加了（64.3 ± 11.3 vs. 74.7 ± 11.2；P 结论：通过与制造商合作开展混合计划，在低血糖高风险的 T1D 患者中将 SAP 大规模转换为 AID 是可行且安全的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrinologia Diabetes Y Nutricion Multiple-

CiteScore

2.10

自引率

10.50%

发文量

期刊介绍： Endocrinología, Diabetes y Nutrición is the official journal of the Spanish Society of Endocrinology and Nutrition (Sociedad Española de Endocrinología y Nutrición, SEEN) and the Spanish Society of Diabetes (Sociedad Española de Diabetes, SED), and was founded in 1954. The aim of the journal is to improve knowledge and be a useful tool in practice for clinical and laboratory specialists, trainee physicians, researchers, and nurses interested in endocrinology, diabetes, nutrition and related disciplines. It is an international journal published in Spanish (print and online) and English (online), covering different fields of endocrinology and metabolism, including diabetes, obesity, and nutrition disorders, as well as the most relevant research produced mainly in Spanish language territories. The quality of the contents is ensured by a prestigious national and international board, and by a selected panel of specialists involved in a rigorous peer review. The result is that only manuscripts containing high quality research and with utmost interest for clinicians and professionals related in the field are published. The Journal publishes Original clinical and research articles, Reviews, Special articles, Clinical Guidelines, Position Statements from both societies and Letters to the editor. Endocrinología, Diabetes y Nutrición can be found at Science Citation Index Expanded, Medline/PubMed and SCOPUS.