906-P: Audit of Technologies Used for Glucose Monitoring and Insulin Delivery in Patients with Type 1 Diabetes at a Single Diabetes Center during 2019–2022—Real-World Data

Abstract

The new NICE guidelines recommend that all adults with type 1 diabetes (T1D) should have access to either Continuous Glucose Monitoring (CGM) orIntermittently Scanned CGM (isCGM). The latest treatment modality for T1D is represented by the hybrid closed-loop systems (HCL), which consist of an insulin pump (CSII), a CGM and a smart algorithm. The aim of the study was to evaluate the effect of methods used for glucose monitoring and insulin delivery on diabetes control in patients with T1D treated during 2019-2022. We analyzed 2132 patients with T1D (48.9% males, mean age 43, 6 years) registered in our Diabetes Centre, 1165 (54.6 %) with multiple daily injections and 967 (45.4 %) using CSII, including 354 (36.6%) using HCL in 2022. A significant increase in the proportion of patients using CGM or isCGM in comparison to Blood Glucose Monitoring (BGM) during the years 2019-2022 was noted (14%/21%/65% in 2019 vs 43%/30%/27% in 2022; p<0.001). There was a significant improvement in diabetes control in CGM and isCGM users between 2019-2022, but not in the BGM group (CGM: 2019 7.9±1.2 % vs. 2022 7.5±1.1 %; p<0.0001; isCGM: 8.1±1.4 % vs. 7.8±1.3 %; p<0.001; BGM: 7.7±1.5 % vs. 7.6±1.5 %; NS). Patients using CGM had better diabetes control than patients with isCGM in 2022 (p<0.001). HbA1c significantly decreased during the past 2 years in all patients using CSII (2020: 8±1.2 % vs. 2022 7.7±1.1 %, p<0.001). In 2022, patients using HCL reached better glycemic control than only CSII users (HCL 7.5±1.2 % vs. CSII 7.8±1.1 %; p˂0.05). Patients using HCL had a significantly more pronounced decrease of glycated hemoglobin between 2020 to 2022 as compared to CSII users (2022: 7.5±1.2 % vs. 2020: 8±1.3 %; p<0.001). Our study demonstrated that more than 2/3 of patients meet the NICE guidelines for glucose monitoring in 2022, and this ratio is improving every year. CGM, isCGM and CSII treatment, especially with HCL are associated with better diabetes control. Disclosure R.Bem: None. D.Vávra: None. K.Sochorova: Advisory Panel; Ypsomed AG, Consultant; Medtronic. M.Müllerová: None. M.Haluzik: Advisory Panel; Novo Nordisk, Lilly Diabetes, Boehringer-Ingelheim, Research Support; Sanofi, Speaker's Bureau; Abbott, AstraZeneca. Funding National Institute for Research of Metabolic and Cardiovascular Diseases (EXCELES LX22NPO5104)