Anandhakrishnan Ananthi, Pender Siobhan, Johnston Thomas, Hyslop Rebecca, Liu Yuk-Fun, Kariyawasam Dulmini, Brackenridge Anna, Karalliedde Janaka, Hussain Sufyan
Department of Diabetes and Endocrinology, Guy's Hospital, Guys and St Thomas' NHS Trust, London, UK.
Department of Diabetes, School of Cardiovascular, Metabolic Medicine and Sciences, King's College London, London, UK.
Diabetes Obes Metab. 2025 Sep;27(9):5052-5063. doi: 10.1111/dom.16553. Epub 2025 Jul 9.
We aimed to evaluate real-world glycaemic outcomes of a tubeless hybrid closed-loop (HCL) insulin delivery system in type 1 diabetes (T1D), exploring the influence of ethnicity and socioeconomic status from a publicly funded system with universal access.
This was a retrospective observational study in adults with T1D initiating HCL (Omnipod® 5) at a large publicly funded multi-site diabetes service. Baseline glycaemic metrics were compared with 12-week post-initiation data. Clinical data and social determinants of health, such as ethnicity and socioeconomic deprivation indices, were analysed for subgroup differences.
One hundred and sixty adults with T1D were included (26.9% non-White; 48.8% in the two most deprived IMD quintiles). Mean time in range (%TIR; 3.9-10 mmol/L) improved from 52.7 ± 16% to 67.9 ± 12.7% (p < 0.001). Improvements were consistent across ethnic groups (mean % TIR +14.8% [95% CI: (12.6%, 17.3%)] and + 16.1% [95% CI: 12.4%, 19.7%] in White and non-White individuals, respectively, p = 0.488) and socioeconomic strata (mean % TIR + 15.9% [95% CI: 13.3%, 18.6%] and + 14.2% [95% CI: 11.2%, 17.1%] in those from lower and higher socioeconomic groups, respectively, p = 0.290). Those with poorer baseline glycaemia experienced greater improvements.
Early real-world use of a tubeless HCL system demonstrated significant and equal glycaemic improvements in diverse ethnic and socioeconomic groups. Promoting universal access to HCL technologies in T1D is therefore essential to ensure existing disparities in glycaemic outcomes are minimised.
我们旨在评估无管混合闭环（HCL）胰岛素输注系统在1型糖尿病（T1D）患者中的实际血糖控制效果，从一个具有普遍可及性的公共资助系统中探索种族和社会经济地位的影响。
这是一项针对在大型公共资助的多中心糖尿病服务机构开始使用HCL（Omnipod® 5）的T1D成年患者的回顾性观察研究。将基线血糖指标与开始使用12周后的数据进行比较。分析临床数据以及健康的社会决定因素，如种族和社会经济剥夺指数，以比较亚组差异。
纳入了160例T1D成年患者（26.9%为非白人；48.8%处于社会经济剥夺指数最高的两个五分位数）。血糖在目标范围内的平均时间（%TIR；3.9 - 10 mmol/L）从52.7 ± 16%提高到67.9 ± 12.7%（p < 0.001）。各民族之间的改善情况一致（白人个体和非白人个体的平均%TIR分别提高14.8% [95%CI：(12.6%, 17.3%)] 和16.1% [95%CI：12.4%, 19.7%]，p = 0.488），社会经济阶层之间也是如此（社会经济地位较低和较高组的平均%TIR分别提高15.9% [95%CI：13.3%, 18.6%] 和14.2% [95%CI：11.2%, 17.1%]，p = 0.290）。基线血糖较差的患者改善更为明显。
早期在实际应用中使用无管HCL系统在不同种族和社会经济群体中均显示出显著且同等程度的血糖改善。因此，促进T1D患者普遍使用HCL技术对于确保将现有的血糖控制结果差异降至最低至关重要。
