Background: Older adults with type 1 diabetes (≥65 years) are often under-represented in clinical trials of automated insulin delivery (AID) systems. We sought to test the efficacy of a recently FDA-approved AID system in this population. Methods: Participants with type 1 diabetes used sensor-augmented pump (SAP) therapy for four weeks and then used an AID system (Control-IQ) for four weeks. In addition to glucose control variables, patient-reported outcomes (PRO) were assessed with questionnaires and sleep parameters were assessed by actigraphy. Results: Fifteen older adults (mean age 68.7 ± 3.3, HbA1c of 7.0 ± 0.8) completed the pilot trial. Glycemic outcomes improved during AID compared to SAP. During AID use, mean glucose was 146.0 mg/dL; mean percent time in range (TIR, 70-180 mg/dL) was 79.6%; median time below 70 mg/dL was 1.1%. The AID system was in use 92.6% ± 7.0% of the time. Compared to SAP, while participants were on AID the TIR increased significantly (+10%, P = .002) accompanied by a reduction in both time above 180 mg/dL (−6.9%, P = .005) and below 70 mg/dl (−0.4%, P = .053). Diabetes-related distress decreased significantly while using AID ( P = .028), but sleep parameters remained unchanged. Conclusions: Use of this AID system in older adults improved glycemic control with high scores in ease of use, trust, and usability. Participants reported an improvement in diabetes distress with AID use. There were no significant changes in sleep.
Background
Data on the use of Control‐IQ, the latest FDA‐approved automated insulin delivery (AID) system for people with T1D 6 years of age or older is still scarce, particularly regarding nonglycemic outcomes. Children with T1D and their parents are at higher risk for sleep disturbances. This study assesses sleep, psycho‐behavioral and glycemic outcomes of AID compared to sensor‐augmented pump therapy (SAP) therapy in young children with T1D and their parents.
Methods
Thirteen parents and their young children (ages 7–10) on insulin pump therapy were enrolled. Children completed an initial 4‐week study with SAP using their own pump and a study CGM followed by a 4‐week phase of AID. Sleep outcomes for parents and children were evaluated through actigraphy watches. Several questionnaires were administered at baseline and at the end of each study phase. CGM data were used to assess glycemic outcomes.
Results
Actigraphy data did not show any significant change from SAP to AID, except a reduction of number of parental awakenings during the night (p = 0.036). Parents reported statistically significant improvements in Pittsburgh Sleep Quality Index total score (p = 0.009), Hypoglycemia Fear Survey total score (p = 0.011), diabetes‐related distress (p = 0.032), and depression (p = 0.023). While on AID, time in range (70–180 mg/dL) significantly increased compared to SAP (p < 0.001), accompanied by a reduction in hyperglycemia (p = 0.001).
Conclusions
These results suggest that use of AID has a positive impact on glycemic outcomes in young children as well as sleep and diabetes‐specific quality of life outcomes in their parents.
OBJECTIVE
Continuous glucose monitoring (CGM) improves diabetes management, but its reliability in individuals on hemodialysis is poorly understood and potentially affected by interstitial and intravascular volume variations.
RESEARCH DESIGN AND METHODS
We assessed the accuracy of a factory-calibrated CGM by using venous blood glucose measurements (vBGM) during hemodialysis sessions and self-monitoring blood glucose (SMBG) at home.
RESULTS
Twenty participants completed the protocol. The mean absolute relative difference of the CGM was 13.8% and 14.4%, when calculated on SMBG (n = 684) and on vBGM (n = 624), and 98.7% and 100% of values in the Parkes error grid A/B zones, respectively. Throughout 181 days of CGM monitoring, the median time in range (70–180 mg/dL) was 38.5% (interquartile range 29.3–57.9), with 28.7% (7.8–40.6) of the time >250 mg/dL.
CONCLUSIONS
The overall performance of a factory-calibrated CGM appears reasonably accurate and clinically relevant for use in practice by individuals on hemodialysis and health professionals to improve diabetes management.
Objective: Continuous glucose monitoring (CGM) improves diabetes
management, but its reliability in individuals on hemodialysis is poorly
understood and potentially affected by interstitial and intravascular volume
variations.
<p>Methods: We
assessed the accuracy of a factory-calibrated CGM, using venous blood glucose
measurements (vBGM) during hemodialysis sessions and self-monitoring blood
glucose (SMBG) at home.</p>
<p>Results: Twenty participants completed the protocol. The mean
absolute relative difference of the CGM was 13.8% and 14.4% when calculated on SMBG
(n=684) and on vBGM (n=624), and 98.7% and 100% of values in the Parkes error
grid A/B zones, respectively. Throughout 181 days of CGM monitoring, the median
time in range (70-180mg/dL) was 38.5% (IQR: 29.3-57.9), with 28.7% (7.8-40.6)
of the time >250mg/dL.</p>
<p>Conclusions. The overall performance of a factory-calibrated CGM
appears reasonably accurate and clinically relevant for use in practice by individuals
on hemodialysis and health professionals to improve diabetes management.</p>
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