Factors of Composite Target of Time in Range and Time below Range among Children and Adolescents with Type 1 Diabetes Mellitus Using Open-Source Automated Insulin Delivery.

Abstract

Objectives: To explore glycemic outcomes after open-source Android artificial pancreas system (AAPS) use and factors of achieving composite target (time in range of 70-180mg/dL [TIR]>70% and time below range of 70mg/dL [TBR70] <4%) among children and adolescents with type 1 diabetes mellitus (T1DM).

Methods: T1DM people aged under 18 years and who used AAPS for ≥6 months were included. Continuous glucose monitoring (CGM) metrics were calculated after 3 and 6 months of AAPS use. Logistic regression model was used to explore factors of achieving composite target at 6 months.

Results: Seventy-seven participants (44.16% male) were included. Median age was 10.64(6.90,12.72) years, T1DM duration was 2.03(0.59,4.43) years and baseline HbA1c was 7.78±2.12%. After 3 and 6 months, 67.53% and 66.23% achieved TIR>70%, while 57.14% and 54.55% achieved TBR70<4%, respectively. After 3 months, the achievement rate composite target was 41.56 % and slightly declined to 35.06 % at 6 months(P>0.05). The age at AAPS initiation (OR=1.32), T1DM duration (OR=0.72), and frequency of daily meal announcements (OR=1.40) were associated factors of achieving composite target at 6 months (all P<0.05).

Conclusions: T1DM children and adolescents with older age, shorter T1DM duration at AAPS initiation, and higher meal announcement frequency during AAPS use had the potential to successfully achieve composite target.