Diabetes technology & therapeutics最新文献

{"title":"Association of Race and Ethnicity with Prescriptions for Continuous Glucose Monitoring Systems Among a National Sample of Veterans with Diabetes on Insulin Therapy.","authors":"Kasia J Lipska, Carol Oladele, Kelson Zawack, Barbara Gulanski, Pradeep Mutalik, Peter Reaven, Julie A Lynch, Kyung Min Lee, Mei-Chiung Shih, Jennifer S Lee, Mihaela Aslan","doi":"10.1089/dia.2024.0152","DOIUrl":"https://doi.org/10.1089/dia.2024.0152","url":null,"abstract":"<p><p><b><i>Introduction and Objective:</i></b> Continuous glucose monitoring (CGM) can improve glycemic control in people with diabetes on insulin therapy. We assessed rates of prescriptions for CGM in a national sample of Veterans across subgroups defined by race and ethnicity. <b><i>Methods:</i></b> This cross-sectional analysis of data from the U.S. Veterans Health Administration included adults with type 1 or type 2 diabetes on insulin therapy. Main exposures included self-reported race and ethnicity, and primary outcome was the percentage of patients with at least one CGM prescription between January 1, 2020, and December 31, 2021. Association of race and ethnicity categories with CGM prescription was examined using multilevel, multivariable mixed-effects models. <b><i>Results:</i></b> Among 368,794 patients on insulin (mean age, 68.5 years; 96% male; 96.8% type 2 diabetes; 0.8% American Indian or Alaska Native, 0.7% Asian, 18.9% Black or African American, 0.9% Native Hawaiian or other Pacific Islander, 70.2% White, 2.8% multiracial, 5.7% with unknown race, and 7.0% Hispanic or Latino ethnicity), 11.2% were prescribed CGM. CGM was prescribed for 10.4% American Indian or Alaska Native, 9.7% Asian, 9.2% Black or African American, 9.3% Native Hawaiian or other Pacific Islander, 11.8% White, 11.8% multiracial, and 10.1% patients with unknown race. CGM was prescribed for 8.3% Hispanic or Latino, 11.4% non-Hispanic, and 11.5% of patients with unknown ethnicity. After accounting for patient-, clinical-, and system-level factors, Black or African American patients had significantly lower odds of CGM prescription compared with White patients (adjusted odds ratio [aOR] 0.62, 95% confidence interval [CI] 0.59-0.64), whereas Hispanic or Latino patients had significantly lower odds compared with non-Hispanic patients (aOR 0.79, 95% CI 0.74-0.84). Findings were consistent across subgroups with clinical indications for CGM use. <b><i>Conclusions:</i></b> Among Veterans with diabetes on insulin therapy, there were significant disparities in prescribing of CGM technology by race and ethnicity, which require further study and intervention.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MiniMed 780G System Use in Type 1 Diabetes During Ramadan Intermittent Fasting: A Systematic Literature Review and Expert Recommendations.","authors":"Nancy Elbarbary, Abdullah Alguwaihes, Hawazen Zarif, Mohamed Hassanein, Asma Deeb, Goran Petrovski, Raed Al Dahash, Reem Alamoudi, Sufyan Hussain, Mahmoud Ibrahim, Shehla Shaikh, Sueziani Binte Zainudin, Wael Chaar, Tim van den Heuvel, Mohammed E Al-Sofiani","doi":"10.1089/dia.2024.0200","DOIUrl":"10.1089/dia.2024.0200","url":null,"abstract":"<p><p>This article offers a systematic literature review (SLR) on the use of the MiniMed 780G automated insulin delivery system (MM780G) in people with type 1 diabetes (PwT1D) during Ramadan intermittent fasting. It also presents consensus recommendations on the use of MM780G during the Ramadan period. The SLR was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. The recommendations resulted from a consensus-forming process involving a panel of experts. The process considered evidence found in the SLR as well as the expert opinions. In total, six studies were included in the SLR. The evidence and expert opinions led to recommendations related to (a) pre-Ramadan counseling of MM780G users who plan to fast; (b) suggested MM780G settings, meal announcement strategy, and safety aspects during Ramadan (including a contingency plan); and (c) post-Ramadan transition into and out of Eid-al-Fitr festivities. The SLR findings showed that the MM780G maintains glycemic control at target in PwT1D during Ramadan (meeting continuous glucose monitoring-based clinical targets proposed by the International Consensus on Time-in-Range) while ensuring low rates of hypoglycemia and diabetic ketoacidosis. Automated insulin delivery also helps PwT1D fast more days of Ramadan compared with users of other less advanced modalities of treatment. Pre-Ramadan guidance on specific aspects of the MM780G along with the International Diabetes Federation and Diabetes and Ramadan International Alliance counseling guidelines is recommended. There is still a challenge with post-Iftar hyperglycemia, which could potentially be mitigated by following the recommendations outlined in this article.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Really Matters?: How Insulin Dose, Timing, and Distribution Relate to Meal Composition in Free-Living People with Type 1 Diabetes.","authors":"Elena Toschi, Stephanie Edwards, Christi Y Kao, Jie Xue, Astrid Atakov-Castillo, Wenjie Wang, Garry Steil, Howard Wolpert","doi":"10.1089/dia.2024.0132","DOIUrl":"10.1089/dia.2024.0132","url":null,"abstract":"<p><p>Optimizing postprandial glucose control in persons with type 1 diabetes (T1D) is challenging. We hypothesized that in free-living individuals, meal composition (high and low glycemic index [HGI and LGI], high and low fat [HF and LF]) may impact insulin requirements. Adults (<i>N</i> = 25) with T1D using open-loop insulin and continuous glucose monitoring were provided a meal-tagging app and prepackaged meals with defined macronutrient content. Data from 463 meals were analyzed. LGI meals required significantly more insulin than HGI meals (<i>P</i> = 0.01). Furthermore, the mean (±standard deviation) carbohydrate-to-insulin ratio (CIR) was significantly different overall among the LGI-LF (5.5 ± 3.4), LGI-HF (4.5 ± 3.8), HGI-LF (7.6 ± 5.1), and HGI-HF (8.7 ± 5.8) meals (<i>P</i> = 0.001). The risk of nocturnal hypoglycemia is associated with daytime hypoglycemia and amount of insulin administered prior to the evening and exercise. This exploratory study designed to examine the impact of different meal types on insulin dosing requirements in free-living adults with T1D emphasizes the need for individualized adjustment of the CIR depending on meal composition.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simplified Meal Management in Adults Using an Advanced Hybrid Closed-Loop System.","authors":"Noga Minsky, Roy Shalit, Andrea Benedetti, Maya Laron-Hirsh, Ohad Cohen, Natalie Kurtz, Anirban Roy, Benyamin Grosman, Amir Tirosh","doi":"10.1089/dia.2024.0224","DOIUrl":"10.1089/dia.2024.0224","url":null,"abstract":"<p><p><b><i>Background:</i></b> The advanced hybrid closed-loop (AHCL) algorithm combines automated basal rates and corrections yet requires meal announcement for optimal performance, which poses a challenge for some. We aimed to compare glucose control in adults with type 1 diabetes (T1D) using the MiniMed^TM 780G AHCL system, utilizing simplified meal announcement versus precise carbohydrate (CHO) counting. <b><i>Methods:</i></b> In a study involving 14 adults with T1D, we evaluated glycemic control during a 13-week \"precise phase,\" followed by two 3- to 4-week simplified meal announcement phases: \"fixed one-step\" (preset of one personalized fixed CHO amount) and \"multistep\" (entry of multiples of one, two, or three of these presets depending on meal size estimate). <b><i>Results:</i></b> The mean age was 45.7 ± 12.4, and 10 participants were male (71%). Mean baseline HbA1c was 6.8% ± 1.2% and time in range (TIR) was 67.5% ± 16.7%. Comparing the fixed one-step to the precise study phase, TIR was similar (75.4 ± 13% vs. 77.7 ± 9%, <i>P</i> = 0.12), and glucose management indicator (GMI) was slightly higher (6.8 ± 0.4 vs. 6.6 ± 0, <i>P</i> = 0.01). Furthermore, there was less level 1 and 2 hypoglycemia (1.6 ± 1% vs. 2.8 ± 2%, <i>P</i> = 0.03 and 0.3 ± 5% vs. 0.65 ± 1%, <i>P</i> = 0.08) but slightly more level 1 and 2 hyperglycemia (17.1 ± 8% vs. 15.0 ± 7%, <i>P</i> = 0.05 and 5.5 ± 5% vs. 3.6 ± 3%, <i>P</i> = 0.04). When comparing the multistep with the precise phase, GMI was identical (6.6%) and TIR superior (80.5 ± 10% vs. 77.7 ± 9%, <i>P</i> = 0.02). Additionally, there was less level 1 hypoglycemia (1.9 ± 1% vs. 2.8 ± 2%, <i>P</i> = 0.01) and a trend for less level 2 hypoglycemia (0.4 ± 0.7% vs. 0.65 ± 1%, <i>P</i> = 0.08). <b><i>Conclusions:</i></b> A simplified meal announcement strategy for adults using the MiniMed 780G system, relying on three increments of a fixed one-step CHO amount, may offer a way to improve glycemic control and ease self-care. For patients with more limitations, using one fixed one-step CHO amount could be a safe alternative to meeting most consensus glycemic targets.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Glucose Metric \"Latest Spike Time\" Correlated with Weight Loss at Six Months in People with Obesity Using the Signos System.","authors":"William Dixon, Stephanie Kim, Dmitri Levonian, Dan Gusz, Sharam Fouladgar-Mercer, Jay S Skyler","doi":"10.1089/dia.2024.0222","DOIUrl":"10.1089/dia.2024.0222","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The rise of digital health applications utilizing continuous glucose monitoring (CGM) allows for novel assessments of glucose management and weight changes in people without diabetes. The Signos System incorporates a digital health app paired with a CGM to provide information and prompts aimed to help people without diabetes to manage weight. <b><i>Objectives:</i></b> The primary objective of this study was to determine whether the average timing of the latest chronological glucose excursion (\"spike\") was correlated with amount of weight loss. <b><i>Methods:</i></b> This was a retrospective analysis of prospectively obtained glucose and weight data from people without diabetes who enrolled in the Signos System from November 2021 to August 2023. Participants were provided CGMs as well as encouraged to use the Signos app with personalized advice and logging capabilities for weight, food, physical activity, heart rate, sleep, and activities. \"Latest spike time\" (LST) was retrospectively derived from CGM data and compared with weight changes at 6 months. <b><i>Results:</i></b> Nine hundred and twenty-six subjects met the inclusion criteria including sufficient days wearing a CGM and a weight log within 15 days of 6 months from their first weight log. There was a strong correlation between an earlier spike time and increased weight loss. The top quintile of subjects, with an average LST before 5:41 PM, lost over three times as much weight as the bottom quintile of users, with LST after 8:40 PM; this separation was predictable within 1 month of data. <b><i>Conclusion:</i></b> In a large population of obese people without diabetes, continuous glucose data, specifically a novel metric \"LST,\" was highly correlated with percentage of total body weight loss at 6 months. This research suggests that for people attempting weight loss, review and alteration of behaviors relating to later glucose excursions may be of specific benefit.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of options to \"Boost\" (enhancing insulin infusion rates) and \"Ease-off\" (reducing insulin infusion rates) in CamAPS FX Hybrid Closed-Loop system: a real-world analysis.","authors":"Chloë Royston, Simon Bergford, Peter Calhoun, Judy Sibayan, Yue Ruan, Charlotte K Boughton, Malgorzata Wilinska, Roman Hovorka","doi":"10.1089/dia.2024.0298","DOIUrl":"https://doi.org/10.1089/dia.2024.0298","url":null,"abstract":"<p><p>The usage and safety of the Boost and Ease-off features in the CamAPS FX hybrid closed-loop system was analysed in a retrospective analysis of real-world data from 7,464 users over a 12-month period. Boost was used more frequently than Ease-off, but for a shorter duration per use. Mean starting glucose was above range for Boost (229±51 mg/dL), and within range for Ease-off (114±29 mg/dL). Time spent below 70 mg/dL was low during Boost periods [median (IQR) 0.0% (0.0, 0.5%)], and lower than during no Boost periods [2.1% (1.2, 3.4%)], while time spent above 180 mg/dL was lower during Ease-off periods (15±14%) compared to no Ease-off periods (25±12%). There were no episodes of severe hypoglycaemia or DKA attributed to Boost or Ease-off use. Boost and Ease-off allow users to engage safely with CamAPS FX to manage their glucose levels during periods of more-than-usual and less-than-usual insulin needs.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Glucose Monitoring: Multianalyte Sensor Use in Diabetes.","authors":"Kathy Zhou, Steven James, Michele Gaca, Ashani Lecamwasam, Muamer Dervisevic, David O'Neal, Nicolas H Voelcker, Elif I Ekinci","doi":"10.1089/dia.2024.0250","DOIUrl":"10.1089/dia.2024.0250","url":null,"abstract":"<p><p>The incidence, prevalence, mortality, and health expenditure associated with diabetes continue to grow, despite efforts. The use of multianalyte sensors, which detect glucose as well as key analytes such as ketones, lactate, insulin, uric acid, and electrolytes, may provide additional information to guide earlier identification and management of diabetes and its complications. We undertook a narrative review using a systematic approach in May 2023, with a bridge search undertaken in April 2024. Four biomedical databases were searched: MEDLINE (Ovid), Embase, Emcare, and Cochrane Library. Searches for gray literature were conducted on ClinicalTrials.gov, Google Scholar, and websites of relevant organizations. Included studies incorporated articles on multianalyte sensors in diabetes and single-analyte sensors proposing integration into multianalyte diabetes management, with no limits placed on publication date and study design. Data were screened and extracted using Covidence^TM software. Overall, 11 articles were included, of which 7 involved multianalyte sensors (involving glucose and other analytes) and 4 single-analyte sensors (measuring non-glucose substances for proposed future integration into multianalyte systems). Analytes examined were ketones (<i>n</i> = 3), lactate (<i>n</i> = 4), uric acid (<i>n</i> = 3), insulin (<i>n</i> = 1), and potassium (<i>n</i> = 1). Results demonstrated that <i>in vitro</i> and <i>in vivo</i> measurements of multi- and single-analyte sensors accurately and reliably corresponded with human capillary and serum samples. While the literature on this topic is sparse, our review demonstrated that measurement of glucose and other analytes can be feasibly undertaken using multi- and single-analyte sensors. More studies in humans are needed to establish clinical utility in diabetes self-management and assist with technological improvements.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency of Rebound Hyperglycemia in Adults with Type 1 Diabetes Treated with Different Insulin Delivery Modalities.","authors":"Katrine Grønbæk Tidemand, Christian Laugesen, Ajenthen Gayathri Ranjan, Liv Boelskifte Skovhus, Kirsten Nørgaard","doi":"10.1089/dia.2024.0134","DOIUrl":"10.1089/dia.2024.0134","url":null,"abstract":"<p><p><b><i>Background:</i></b> For people with type 1 diabetes (T1D), ensuring fast and effective recovery from hypoglycemia while avoiding posthypoglycemic hyperglycemia (rebound hyperglycemia, RH) can be challenging. The objective of this study was to investigate the frequency of RH across different treatment modalities and its impact on glycemic control. <b><i>Methods:</i></b> This cross-sectional real-world study included adults with T1D using continuous glucose monitoring and attending the outpatient clinic at Steno Diabetes Center Copenhagen. RH was defined as ≥1 sensor glucose value (SG) >10.0 mmol/L (180 mg/dL) starting within 2 h of an antecedent SG <3.9 mmol/L (70 mg/dL). The severity of the RH events was calculated as area under the curve (AUC) and separately for users of multiple daily injections (MDIs), unintegrated insulin pumps, sensor augmented pumps (SAPs), and automated insulin delivery (AID), respectively. <b><i>Results:</i></b> Across the four groups, SAP and AID users had the highest incidence of RH (2.06 ± 1.65 and 2.08 ± 1.49 events per week, respectively) and a similar percentage of hypoglycemic events leading to RH events (41.3 ± 22.8% and 39.6 ± 20.1%, respectively). The AID users with RH events were significantly shorter compared with MDI users (122 ± 72 vs. 185 ± 135 min; <i>P</i> < 0.0001). Overall, severity of RH was inversely associated with more advanced technology (<i>P</i> < 0.001) and inversely associated (<i>P</i> < 0.001) with time in target range (TIR). <b><i>Conclusions:</i></b> Groups with insulin suspension features experienced the highest frequency of RH; however, AID users tended to experience shorter and less severe RH events. The association between the severity of RH events and TIR suggests that RH should be assessed and used in the guidance of hypoglycemia management.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should We Bury HbA1c?","authors":"Laura B Bovee, Irl B Hirsch","doi":"10.1089/dia.2024.0028","DOIUrl":"10.1089/dia.2024.0028","url":null,"abstract":"","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139729236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized Trial of Assisted Hybrid Closed-Loop Therapy Versus Sensor-Augmented Pump Therapy in Pregnancy.","authors":"Sarit Polsky, Elizabeth Buschur, Kathleen Dungan, Rachel Garcetti, Emily Nease, Emily Malecha, Anna Bartholomew, Carly Johnson, Laura Pyle, Janet Snell-Bergeon","doi":"10.1089/dia.2024.0012","DOIUrl":"10.1089/dia.2024.0012","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Examine gestational safety, glycemic and health outcomes, of a hybrid closed-loop (HCL) system without pregnancy-specific glucose targets. <b><i>Research Design:</i></b> This was a pilot feasibility investigator-initiated, two-site, single-blind, randomized controlled trial of sensor-augmented pump therapy (SAPT) versus HCL therapy in type 1 diabetes pregnancies. Participants were enrolled in the first trimester and randomized at 14-18 weeks of gestation and used SAPT or HCL until 4-6 weeks postpartum. We compared continuous glucose monitoring (CGM) metrics, severe hypoglycemia (SH), diabetic ketoacidosis (DKA), adverse skin reactions, and pregnancy outcomes between groups. <b><i>Results:</i></b> Baseline characteristics were similar between groups (<i>n</i> = 11 HCL and <i>n</i> = 12 SAPT). There was no SH or DKA episode after randomization. Time spent <54 mg/dL did not differ between groups. Time spent <63 mg/dL decreased in both groups, significantly in the HCL group (3.5% [1.3% standard error] second trimester and 2.8% [1.3%] third trimester vs. 7.9% [1.3%] run-in phase, <i>P</i> < 0.05 for both). Mean sensor glucose was lower with SAPT compared to HCL therapy in the third trimester (119 [4] mg/dL SAPT vs. 132 [4] mg/dL HCL, <i>P</i> < 0.05). Third trimester time-in-range (TIR; 63-140 mg/dL) increased with SAPT (68.2% [3.1%] vs. 64.3% [3.1%] run-in phase, <i>P</i> < 0.05). Gestational health outcomes did not differ between groups. The HCL group used assistive techniques, such as fake carbohydrate boluses and exiting HCL overnight. <b><i>Conclusions:</i></b> CGM within group differences were seen for time <63 mg/dL favoring HCL therapy and TIR favoring SAPT (third trimester vs. baseline). Safety and adverse pregnancy outcomes were similar between groups.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139930414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}