Study: Automated Insulin Delivery Improves Time in Range
By Andrew Briskin
An analysis shows Tandem’s Control-IQ automated insulin delivery system boosts time in range by three hours per day, largely due to the system's auto-correction feature.
The study published in Diabetes Technology & Therapeutics showed that time in range (TIR) improvements from the hybrid-closed loop technology were seen among all participants, regardless of age, race, income, starting A1C, or prior use of diabetes technology.
The meta-analysis of 3 studies included data from 369 people with type 1 diabetes from ages 2 to 72 years, 256 of whom used the Control-IQ system. This data was compared to glucose data mostly from people using a pump without the Control-IQ algorithm, although some injected insulin multiple times per day. Regardless, all participants wore Dexcom G6 continuous glucose monitors (CGM) to track their glucose levels.
Among those using Control-IQ, TIR increased from an average of 57% to 70% over the course of the 13-week trial. For those not on Control-IQ, TIR was nearly constant, going from 56% to 57%. Researchers noted that the TIR improvement from using Control-IQ occurred quickly, after only one day of use and remained stable throughout the trial. Control-IQ had the most significant effect on improving TIR in the early hours of the morning between 4 and 8 a.m., without increasing the risk for hypoglycemia.
In a closer look at the data, researchers found that the participants with the highest glucose levels at the beginning of the study experienced the most dramatic improvements in A1C; those with a starting A1C above 8.5% had an almost 1 percentage point drop in A1C.
This group was also more likely to rely on the system’s automated bolus feature for mealtime dosing and corrections, as opposed to initiating the dose manually. Despite the fact that those with a high starting A1C did not bolus manually, their improvement was even greater. The article concluded that hybrid-closed loop technology should be strongly considered for all youth and adults with T1D.
In an announcement, Dr. Roy Beck, first author on the study and former executive director of the Jaeb Center for Health Research, said “Control-IQ technology delivered the most robust improvements in those entering the study with the highest hemoglobin A1C and lowest time in range. The high number of automatic boluses given by the system in this group likely reflect previously missed meal boluses or lack of manual correction boluses when on conventional therapy and demonstrates the substantial impact Control-IQ technology’s auto-bolusing feature can have for people struggling on a standard pump or multiple daily injections.”
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