Real-world evaluation of automated insulin delivery therapy in type 1 diabetes: A multicentre study across regional and metropolitan Queensland, Australia

IF 5.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism Pub Date : 2025-05-28 DOI:10.1111/dom.16485

Akash Konantambigi MBBS, Wenyong Wang RN, Dylan Boggild MBBS, Arushi Rana MBBS, Larisa Syphers MBBS, Catherine Presley RN, Candice Cummins RN, Usman Malabu FRACP, Kate Hawke FRACP, Vasant Shenoy FRACP, Gaurav Puri FRACP, Harshal Deshmukh FRACP

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Abstract

Background

Automated insulin delivery (AID) systems, which integrate continuous glucose monitoring (CGM) with automated insulin dosing, have emerged as a transformative therapy. However, real-world data on AID effectiveness, particularly in regional Australia, remain limited.

Methods

We conducted a retrospective audit across three Australian hospital sites—Logan (metropolitan), Mackay and Townsville (regional)—to evaluate the impact of AID therapy in adults with Type 1 Diabetes Mellitus (T1DM). Data on demographics, comorbidities, CGM metrics and clinical outcomes were extracted from medical records and device platforms. The primary outcome was change in HbA1c and CGM time-in-range (TIR; 3.9–10 mmol/L) at follow-up. Follow-up data were recorded up to 12 months following AID commencement. Secondary outcomes included changes in body weight, glycaemic variability and predictors of HbA1c reduction.

Results

The study consisted of 158 people living with T1DM who were initiated on AID. Following AID initiation, mean TIR improved from 53.4% (SD 21.1%) to 70.0% (SD 14.6%) (p < 0.0001), and time in hyperglycaemia (>13.9 mmol/L) declined from 18.7% (SD 19.4%) to 8.4% (SD 9.31%) (p < 0.0001). The mean HbA1c significantly decreased from 8.62% (SD 1.70) at baseline to 7.34% (SD 1.31) at follow-up across the entire study cohort (p < 0.0001), with 42.7% achieving <7% and 64.1% achieving <7.5% at follow-up. Multivariable regression identified higher baseline HbA1c (p < 0.0001) as a significant predictor of HbA1c reduction. Improvements were consistent across AID system types and geographical settings.

Conclusions

AID therapy significantly improves glycaemic control in adults with T1DM in both regional and metropolitan Australia. Our findings support the real-world effectiveness of AID systems and highlight their potential to bridge care gaps across diverse settings.

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1型糖尿病自动胰岛素输送治疗的真实世界评估：澳大利亚昆士兰地区和大都市的多中心研究

背景：自动胰岛素输送（AID）系统将连续血糖监测（CGM）与自动胰岛素给药相结合，已经成为一种变革性的治疗方法。然而，关于艾滋病有效性的真实数据，特别是澳大利亚地区的数据仍然有限。方法：我们对澳大利亚的三家医院——logan（大城市）、Mackay和Townsville（地区）进行了回顾性审核，以评估aids治疗对成人1型糖尿病（T1DM）的影响。人口统计学、合并症、CGM指标和临床结果的数据从医疗记录和设备平台中提取。主要终点是HbA1c和CGM的变化时间范围(TIR；3.9-10 mmol/L)。AID开始后12个月的随访数据记录。次要结局包括体重变化、血糖变异性和HbA1c降低的预测因子。结果：该研究包括158名T1DM患者，他们开始接受艾滋病治疗。AID启动后，平均TIR从53.4% （SD 21.1%）改善到70.0% (SD 14.6%) (p 13.9 mmol/L)，从18.7% （SD 19.4%）下降到8.4% (SD 9.31%) (p结论：AID治疗显著改善了澳大利亚地区和大城市成人T1DM患者的血糖控制。我们的研究结果支持了艾滋病系统在现实世界中的有效性，并强调了它们在弥合不同环境下的护理差距方面的潜力。

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来源期刊

Diabetes, Obesity & Metabolism 医学-内分泌学与代谢

CiteScore

10.90

自引率

6.90%

发文量

319

审稿时长

3-8 weeks

期刊介绍： Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.