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. 2022 Feb;24(2):140-142.
doi: 10.1089/dia.2021.0311. Epub 2021 Oct 28.

Closed-Loop Insulin Therapy in Older Adults with Type 1 Diabetes: Real-World Data

Elena Toschi  1   2 , Astrid Atakov-Castillo  1 , Christine Slyne  1 , Medha Munshi  1   2   3
Affiliations

Closed-Loop Insulin Therapy in Older Adults with Type 1 Diabetes: Real-World Data

Elena Toschi et al. Diabetes Technol Ther. 2022 Feb.

Abstract

Objective: To assess the impact of initiation of closed-loop control (CLC) on glycemic metrics in older adults with type 1 diabetes (T1D) in the real world. Methods: Retrospective analysis of electronic health records from a single tertiary diabetes center of older adults prescribed CLC between January and December 2020. Results: Forty-eight patients (mean age 70 ± 4 years, T1D duration 42 ± 14 years) were prescribed CLC and 39/48 started on the CLC. Among the CLC starters, 97.5% and 95% were prior pump and continuous glucose monitoring (CGM) users, respectively. CGM metrics showed an increase in time-in-range (62% ± 13% to 76% ± 9%; P < 0.001), a reduction in both time spent <70 mg/dL [2% (1%-3%) to 1% (1%-2%); P = 0.03] and >180 mg/dL (30% ± 11% to 20% ± 9%; P < 0.001) at 3 months. Conclusion: In this real-world data most of the older patients with T1D initiating CLC were prior pump and CGM users. Initiation of CLC improved glycemic control and reduced time spent in hypoglycemia compared with prior therapy.

Keywords: Closed-loop systems; Continuous glucose monitoring; Type 1 diabetes; Underrepresented populations.

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Conflict of interest statement

E.T. is a consultant for Medtronic Diabetes. M.N.M. is a consultant for Sanofi and Eli Lilly. A.A.-C. and C.S. have no duality of interest.

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