129-LB: A Comparison of CGM Metrics in People with Type 1 Diabetes Treated with Different Insulin Modalities

Abstract

Background: There is a lack of real-world data comparing CGM data across different insulin treatment modalities. This study examined the association between CGM-measured glycemic metrics and different insulin treatment modalities in a large type 1 diabetes clinic. Methods: Individuals with type 1 diabetes attending Steno Diabetes Center Copenhagen, Denmark, were eligible for inclusion if they had ≥70% CGM data available within a four-week period within the past year. Participants were divided into four groups based on their insulin treatment: multiple daily injections (MDI +/- alarms), sensor unintegrated insulin pumps (SUP +/- alarms), sensor-augmented insulin pumps (SAP), and automated insulin delivery systems (AID). The latest measured HbA1c and CGM were analyzed. Results: Of 6,319 attendees, 2,689 met the inclusion criteria: 1405 with MDI, 453 with SUP, 307 with SAP, and 524 with AID. Compared to the MDI - alarms group, a clinically relevant lower mean HbA1c was found in the SAP (0.5%; 95% CI:0.3-0.6) and the AID group (0.7%; 95% CI:0.6-0.9) (adjusted for sex, age and diabetes duration). CGM metrics for the four different treatment groups are presented. Conclusion: The results suggest that AID was superior to all other insulin delivering systems with CGM. Although results may be affected by bias due to indication, the expansion of AID use to a wider type 1 population should be considered. Disclosure K. Nørgaard: Advisory Panel; Medtronic, Novo Nordisk, Research Support; Medtronic, Dexcom, Inc., Novo Nordisk, Zealand Pharma A/S, Speaker's Bureau; Medtronic, Novo Nordisk, Stock/Shareholder; Novo Nordisk. B. Carstensen: Stock/Shareholder; Novo Nordisk. A. G. Ranjan: None. C. Laugesen: Employee; Novo Nordisk A/S, Stock/Shareholder; Novo Nordisk A/S. K. G. Tidemand: None. H. U. Andersen: None. J. Svensson: Other Relationship; Medtronic, Sanofi, Rubin MEdical, Research Support; Novo Nordisk, Medtronic, Stock/Shareholder; Novo Nordisk. C. Selmer: Other Relationship; Boehringer-Ingelheim, Novo Nordisk. A. Green: None. D. Vistisen: Research Support; Bayer Inc., Sanofi, Boehringer-Ingelheim, Stock/Shareholder; Novo Nordisk A/S.