652-P: Gaps Remain in Achieving Target T1D Glycemic Goals Despite Advanced Technologies

Abstract

Continuous glucose monitoring (CGM) metrics and self-reported disease characteristics (severe hypoglycemic events [SHEs], HbA1c) warrant further description in people with T1D using CGM and pumps, including hybrid closed-loop systems (HCLS) . We conducted a one-time online survey of adults with T1D in the T1D Exchange Registry or online communities, where ∼50% of participants contributed up to 1 year of CGM data. Patients were asked about their medical history (SHEs, HbA1c) , while glucose management indicator (GMI) , prolonged hypoglycemic events (<54 mg/dL) , time in and below range (TIR/TBR) , and coefficient of variation (CV) were derived from CGM data. Patients who completed the survey and contributed CGM data (N=926) had a mean age of 42 y and T1D duration of 25 y; 73% were female; 96% were white; 94% had ≥1 year of CGM use. Mean HbA1c was 6.6% (69.0% had HbA1c <7%) . While most patients met consensus glycemic targets (HbA1c, GMI, TIR, TBR, and CV) , with higher proportions observed in those using HCLS pumps than in those using pump + CGM (not HCLS) and MDI + CGM (Table) , patients continued to have significant hypoglycemia based on CGM data and an average of 1.1 SHEs in the prior year. Despite improvements in glycemic control (TIR, TBR, and self-reported HbA1c) with advanced technologies, many patients still cannot achieve clinical targets and experience significant hypoglycemia, highlighting the unmet need for novel T1D treatments. Disclosure L.M.Laffel: Advisory Panel; Medtronic, Roche Diabetes Care, Consultant; Boehringer Ingelheim International GmbH, Dexcom, Inc., Dompé, Insulet Corporation, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk, Provention Bio, Inc. K.S.M.Chapman: None. D.Finan: None. R.M.Bergenstal: Advisory Panel; Hygieia, Medtronic, Roche Diabetes Care, Zealand Pharma A/S, Consultant; Abbott Diabetes, Ascensia Diabetes Care, Bigfoot Biomedical, Inc., CeQur SA, Dexcom, Inc., Eli Lilly and Company, Novo Nordisk, Onduo LLC, Sanofi, United HealthCare Services, Inc., Research Support; Abbott Diabetes, Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Medtronic, Novo Nordisk, Sanofi. J.Liu: None. L.Titievsky: Employee; Intercept Pharmaceuticals, Inc., Pfizer Inc., Vertex Pharmaceuticals Incorporated, Stock/Shareholder; Intercept Pharmaceuticals, Inc., Pfizer Inc., Vertex Pharmaceuticals Incorporated. K.Hagan: Employee; Vertex Pharmaceuticals Incorporated. T.Liu: Employee; Takeda Pharmaceutical Company Limited, Vertex Pharmaceuticals Incorporated, Stock/Shareholder; Seattle Genetics, Inc. K.Chandarana: Employee; Vertex Pharmaceuticals Incorporated. J.L.Gaglia: Advisory Panel; Dompé, Regeneron Pharmaceuticals Inc., Consultant; Vertex Pharmaceuticals Incorporated, Research Support; Avotres Inc., Dompé, Janssen Research & Development, LLC, Provention Bio, Inc., Stock/Shareholder; Vertex Pharmaceuticals Incorporated. W.Wolf: None. J.Bispham: Employee; PPD Inc., T1D Exchange.