Adults With Type 2 Diabetes Benefit From Automated Insulin Delivery Irrespective of C-Peptide Level.

IF 16.6

Diabetes care Pub Date : 2025-09-15 DOI:10.2337/dc25-1125

Irl B Hirsch, Yogish C Kudva, David T Ahn, Thomas Blevins, Michael R Rickels, Dan Raghinaru, John W Lum, Craig Kollman, Jordan E Pinsker, Roy W Beck

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Abstract

Objective: The Centers for Medicare & Medicaid Services (CMS) requires a low C-peptide level for insulin pump coverage unless the individual is β-cell autoantibody positive, which precludes coverage of automated insulin delivery (AID) systems for many people with type 2 diabetes.

Research design and methods: In the Randomized Trial Evaluating the Efficacy and Safety of Control-IQ+ Technology in Adults With Type 2 Diabetes Using Basal-Bolus Insulin Therapy study evaluating the t:slim X2 insulin pump with Control-IQ+ technology, adults with insulin-treated type 2 diabetes were categorized into high C-peptide (n = 195) and low C-peptide (n = 59) groups based on CMS criteria.

Results: In the AID group, mean HbA1c decreased from baseline by 0.8%, which was significantly greater than in the control group with both high (P < 0.001) and low (P = 0.02) C-peptide levels. Results were similar in participants ≥65 years old.

Conclusions: The benefit of AID is present with high and low C-peptide levels. Thus, requiring a low C-peptide level as a prerequisite for AID therapy is not warranted.

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成人2型糖尿病患者受益于自动胰岛素输送，与c肽水平无关。

目的：医疗保险和医疗补助服务中心（CMS）要求胰岛素泵覆盖低c肽水平，除非个人是β细胞自身抗体阳性，这排除了许多2型糖尿病患者自动胰岛素输送（AID）系统的覆盖。研究设计与方法：在《评价采用Control-IQ+技术的t:slim X2胰岛素泵在成人2型糖尿病患者基础胰岛素治疗中的疗效和安全性的随机试验》中，根据CMS标准将胰岛素治疗的成人2型糖尿病患者分为高c肽组（n = 195）和低c肽组（n = 59）。结果：AID组平均HbA1c较基线下降0.8%，显著高于c肽水平高（P < 0.001）和低（P = 0.02）的对照组。≥65岁的参与者的结果相似。结论：AID的益处存在于高和低c肽水平。因此，要求低c肽水平作为艾滋病治疗的先决条件是不合理的。

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

Diabetes care

CiteScore

29.50

自引率

0.00%

发文量