Real-World Clinical Impact of Using Personal Glucose Targets in a Hybrid Closed-Loop System Differs According to Age.

Abstract

Objective: CamAPS FX is a customizable hybrid closed-loop app with a default target glucose of 105 mg/dL. The personal glucose target is user-adjustable in 1 mg/dL increments between 80 and 198 mg/dL in 30-min segments over 24 h. We assessed the impact of different personal glucose targets on glycemic control during real-world use of CamAPS FX in different age-groups. Methods: We retrospectively analyzed data from real-world CamAPS FX users from 11 countries across all age-groups (1 to 90 years), who used the system between December 1, 2022 and November 30, 2023, and had a minimum of 8 weeks of closed-loop use. Every sensor glucose reading was matched to the user-specified glucose target. Results: In total, 8604 users (mean age 32 ± 19 years, median days of data 89 [IQR 59, 119]) were included. Personal glucose targets were most frequently used by very young children (>50%), followed by school-aged children (>40%). All other age-groups used the default target 65%-68% of the time. Overall, personal glucose targets >120 mg/dL were associated with time in target range <70%. Time <70 mg/dL remained <4% across targets, apart from at the lowest (80-89 mg/dL). Older adults achieved time in range ≥70% across all targets. Very young children and young adults were only able to achieve time in range >70% with targets set below the default, which was associated with time <70 mg/dL of >4% in very young children. Conclusions: Personal glucose targets are frequently used, with clinical impact differing depending on user-age. Adjusting glucose targets may help to achieve recommended glycemic targets and individual glycemic goals.