Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Department of Diabetes, Endocrinology and Metabolic Diseases, Kantonsspital Olten, Olten, Switzerland.
Swiss Med Wkly. 2023 Dec 15;153:3501. doi: 10.57187/s.3501.
To assess glucose levels in adults with diabetes at a Swiss tertiary hospital when transitioning from insulin delivery with a sensor-augmented pump with (predictive) low-glucose suspend ([P]LGS) to a hybrid-closed loop (HCL) and from a HCL to an advanced hybrid-closed loop (AHCL).
Continuous glucose monitoring data for 44 adults with type 1 diabetes transitioning from (P)LGS to hybrid-closed loop and from hybrid-closed loop to advanced hybrid-closed loop were analysed, including the percentage of time spent within, below, and above glucose ranges. In addition, a subgroup analysis (n = 14) of individuals undergoing both transitions was performed.
The transition from a (P)LGS to a hybrid-closed loop was associated with increased time in range (6.6% [2.6%-12.7%], p <0.001) and decreased time above range (5.6% [2.3%-12.7%], p <0.001). The transition from a hybrid-closed loop to an advanced hybrid-closed loop was associated with increased time in range (1.6% [-0.5%-4.5%], p = 0.046) and decreased time above range (1.5% [-1.8%-5.6%], p = 0.050). Both transitions did not change the time below range. In the subgroup analysis ([P]LGS → HCL → AHCL), the time in range increased from 69.4% (50.3%-79.2%) to 76.5% (65.3%-81.3%) and 78.7% (69.7%-85.8%), respectively (p <0.001).
Glucose levels significantly improved when transitioning from a (P)LGS to a hybrid-closed loop. Glucose levels improved further when switching from a hybrid-closed loop to an advanced hybrid-closed loop. However, the added benefit of an advanced hybrid-closed loop was comparably smaller. This pattern was also reflected in the subgroup analysis.
评估瑞士一家三级医院使用传感器增强型胰岛素输送泵（具有预测性低血糖暂停功能）[P]LGS 切换到混合闭环[HCL]和从 HCL 切换到高级混合闭环[AHCL]时，糖尿病成人的血糖水平。
分析了 44 例从（P）LGS 切换到混合闭环和从混合闭环切换到高级混合闭环的 1 型糖尿病患者的连续血糖监测数据，包括血糖范围内、低于和高于血糖范围的时间百分比。此外，对进行两次转换的个体（n = 14）进行了亚组分析。
从（P）LGS 切换到混合闭环与血糖范围内的时间增加（6.6% [2.6%-12.7%]，p <0.001）和血糖范围以上的时间减少（5.6% [2.3%-12.7%]，p <0.001）有关。从混合闭环切换到高级混合闭环与血糖范围内的时间增加（1.6% [-0.5%-4.5%]，p = 0.046）和血糖范围以上的时间减少（1.5% [-1.8%-5.6%]，p = 0.050）有关。这两种转换均未改变血糖范围以下的时间。在亚组分析中（[P]LGS→HCL→AHCL），血糖范围内的时间从 69.4%（50.3%-79.2%）增加到 76.5%（65.3%-81.3%）和 78.7%（69.7%-85.8%）（p <0.001）。
从（P）LGS 切换到混合闭环时，血糖水平显著改善。从混合闭环切换到高级混合闭环时，血糖水平进一步改善。然而，高级混合闭环的附加益处相对较小。这种模式在亚组分析中也得到了反映。
