Hybrid closed-loop insulin system well tolerated, effective for lowering HbA1c
HOUSTON — A retrospective chart review of adults with type 1 diabetes who used the Medtronic MiniMed 670G revealed generally favorable experiences with the technology as well as improvements in HbA1c, according to findings presented at the American Association of Diabetes Educators annual meeting.
“There is a huge push to improve glycemic control and decrease the burden of diabetes management with automated insulin delivery,” Lisa T. Meade, PharmD, CDE, professor of pharmacy at Wingate University in North Carolina and a clinical pharmacist and certified diabetes educator in the department of endocrinology at Piedmont Healthcare, told Endocrine Today. “Many times, patients come in with unrealistic expectations, so I feel this type of research is important to assist providers and educators with patient education and setting realistic expectations.”
Thirty-three adults with type 1 diabetes completed a survey to assess satisfaction with glucose monitoring after 3 months or more using the MiniMed 670G, which distributes insulin via a hybrid closed-loop system with both automated and suspend-before-low features. In addition to the survey, HbA1c was assessed quarterly from baseline to 12 months.
At 6 months, the average HbA1c in the cohort fell by 0.9% vs. baseline (P = .015), and at 12 months, HbA1c had been reduced by 1.2% vs. baseline (P = .001), according to Meade, who also observed that participants averaged five blood glucose checks per day compared with 4.2 before hybrid closed-loop system initiation (P = .018).
Based on the survey, an average satisfaction score of 3.79 (score range, 1-5) was reported by participants, who also experienced time-in-range benefits.
“We were encouraged with the mean time in range of 67%, but we also see room for improvement. The American Diabetes Association recommends patients spend at least 70% of their time between 70 mg/dL and 180 mg/dL, so we will continue to work with patients to increase time in range,” Meade said. “The study did confirm the need for better office procedures to track patients starting on new technology and to ensure regular follow-up visits.” – by Phil Neuffer
Meade LT, et al. P811. Presented at: American Association of Diabetes Educators; Aug. 9-12, 2019; Houston.
Disclosure: Meade reports she is a certified pump trainer for Medtronic.