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Real-World Use of Closed-Loop Insulin Delivery Systems and Continuous Glucose Monitoring

Two reports examine the use of hybrid closed loop (HCL) insulin delivery systems and continuous glucose monitoring (CGM) in real-world settings.

In National Health Service England diabetes facilities, the real-world use of HCL by 570 participants with type 1 diabetes was associated with improvements in glycosylated hemoglobin (HbA1c) levels, time in range, hypoglycemia, and diabetes-related stress in people with type 1 diabetes, researchers report. “Time in range (70–180 mg/dL) increased from 34.2 to 61.9% (P < 0.001). Individuals with HbA1c of ≤58 mmol/mol rose from 0 to 39.4% (P < 0.0001), and those achieving ≥70% glucose time in range and <4% time below range increased from 0.8 to 28.2% (P < 0.0001). Almost all participants rated HCL therapy as having a positive impact on quality of life (94.7% [540 of 570]).”

Analysis of records of hospitalized patients showed that inpatient CGM accuracy at a large safety-net hospital was acceptable in both critically ill and non-criticially ill patients. Compared with laboratory CGM values, point-of-care CGM accuracy was slightly less accurate (96.5% versus 99.1%), particularly in patients with poor circulation, ECMO, and severe anorexia. “Further exploration of conditions associated with lower CGM accuracy in real-world settings is warranted,” the investigators conclude.

Source: Diabetes Care