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19-01-2022 | Diabetes | News | Article

News in brief

Closed-loop benefits differ with high or low baseline HbA1c

Author: Eleanor McDermid

medwireNews: Researchers find that the type of benefits people with type 1 diabetes gain from hybrid closed-loop insulin delivery differs according to their baseline glycemic control.

Fourteen of the 168 participants of the International Diabetes Closed-Loop (iDCL) trial had tightly controlled glucose levels (glycated hemoglobin [HbA1c] <6.5%, 48 mmol/mol). For these individuals, the main benefit of closed-loop delivery came at night, when automated adjustment of the basal insulin rate resulted in a 6.8% reduction in nocturnal hypoglycemia.

At the other end of the range, the 14 people with baseline HbA1c of 8.5% or higher had the largest reductions in time spent in hyperglycemia (>180 mg/dL, 10 mmol/L), by 19.2% during the day and 30.4% overnight. This was partly due to the system administering a high number of automated correction boluses; this group received a median of 5.7 per day, whereas those with tight glucose control received a median of just 1.9 in a day.

The high number in the group with HbA1c over 8.5% is “in apparent compensation for missed meal boluses,” write Laya Ekhlaspour (Stanford University School of Medicine, California, USA) and study co-authors in Diabetes Technology & Therapeutics.

The researchers say that many closed-loop studies excluded people with very tightly or poorly controlled glucose levels, but say that their findings “are a strong argument for not having restrictions on who should have access to this technology.”

They stress: “Potential users should not be excluded because they have already achieved recommended HbA1c targets, or because they have high HbA1c levels.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group

Diabetes Technol Ther 2022; doi:10.1089/dia.2021.0524

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