Ayman Al Hayek, Wael M. Alzahrani, Abdulghani H. Al Saeed, Malak Al Mashali, David C. Klonoff, Mohamed A. Al Dawish
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引用次数: 0
摘要
先进的混合闭环（AHCL）系统已显示出改善成人1型糖尿病（T1D）血糖控制的希望，但实际证据仍然有限。本研究评估了从每日多次注射（MDI）或传统连续皮下胰岛素输注（CSII）过渡到Tandem t:slim X2™Control-IQ®AHCL系统对成年T1D患者血糖结局的影响。方法：回顾性研究56例未怀孕的成年T1D患者，随访6个月。主要结局是血糖危险指数（GRI）的变化和处于紧张范围的百分比时间（%TiTR70-140）。次要结果包括其他标准化的动态血糖指标以及额外的血糖、人体测量和胰岛素剂量测量。结果：过渡到Control-IQ系统使%TiTR70-140提高了11.5个百分点，GRI降低了23.5个百分点。GRI的两个组成部分，低血糖风险（%Chypo）和高血糖风险（%Chyper）显著改善。血红蛋白A1c下降1.0%，范围时间（%TIR70-180）改善13.6个百分点，血糖变异性（CV%）明显改善。每日胰岛素总剂量减少了34%，并伴有适度的体重减轻。在整个研究期间没有糖尿病酮症酸中毒发作的报道。结论：过渡到Tandem t:slim X2 control - iq AHCL系统可显著改善严密血糖控制、降低血糖风险和胰岛素效率，并具有良好的安全性。这些发现支持AHCL技术的广泛采用，并强调了前瞻性多中心研究的必要性。
Evaluation of Glycemia Risk Index and Continuous Glucose Monitoring Outcomes Following the Transition to an Advanced Hybrid Closed-Loop System in Type 1 Diabetes
Introduction
Advanced hybrid closed-loop (AHCL) systems have shown promise in improving glycemic control in adults with type 1 diabetes (T1D), yet real-world evidence remains limited. This study evaluated the impact of transitioning from multiple daily injections (MDI) or conventional continuous subcutaneous insulin infusion (CSII) to the Tandem t:slim X2™ Control-IQ® AHCL system on glycemic outcomes in adults with T1D.
Methods
In this retrospective study, 56 non-pregnant adults with T1D were followed for 6 months. Primary outcomes were changes in the Glycemia Risk Index (GRI) and percentage time in the tight range (%TiTR70-140). Secondary outcomes included other standardized ambulatory glucose profile metrics as well as additional glycemic, anthropometric, and insulin dosing measures.
Results
Transition to the Control-IQ system increased %TiTR70-140 by 11.5 percentage points and reduced GRI by 23.5 points. Both components of the GRI, hypoglycemia risk (%Chypo) and hyperglycemia risk (%Chyper), improved significantly. Hemoglobin A1c decreased by 1.0%, time in range (%TIR70-180) improved by 13.6 percentage points, and glycemic variability (CV%) showed marked improvement. Total daily insulin dose decreased by 34%, accompanied by modest weight loss. No diabetic ketoacidosis episodes were reported throughout the study period.
Conclusion
Transitioning to the Tandem t:slim X2 Control-IQ AHCL system led to significant improvements in tight glycemic control, glycemic risk reduction, and insulin efficiency, with a favorable safety profile. These findings support broader adoption of AHCL technology and underscore the need for prospective multicenter studies.
期刊介绍：
Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged.
The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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