Transitioning between automated insulin delivery systems: A focus on personalisation

Abstract

Background

Automated insulin delivery (AID) systems are the most effective treatment for type 1 diabetes (T1D). When targets are not achieved, transitioning between AID systems is an option. The aim was to assess the impact of switching between systems on glucose control and user satisfaction.

Methods

A multicenter, cross-sectional analysis was conducted. T1D subjects who had switched between AID systems were included. Glycaemic control was compared before the switch, after 14 days, and after 3 months of use of the new system. The participants completed a satisfaction survey.

Results

96 subjects were included (age: 40.8 ± 11.5 years, 73 % female, HbA1c: 6.94 ± 0.68 % (52.3 ± 7 mmol/mol)). The AID systems evaluated included MiniMed^TM-780G, Diabeloop-DBLG1, Tandem-t:slim-x2^TM-Control-IQ^TM, and CamAPS-FX. GMI improved from 6.92 ± 0.49 % to 6.71 ± 0.37 % after 14 days and to 6.68 ± 0.36 % after 3 months and Time in Range 70–180 mg/dl increased from 70.53 ± 11.43 % to 75.73 ± 8.33 % after 14 days and to 75.65 ± 7.64 % after 3 months (p < 0.001 to baseline). The majority of the participants reported higher satisfaction. The factors that most affected satisfaction were the size of the system, the performance of the sensor, and the specificities of the control algorithm.

Conclusion

Transitioning between AID systems can enhance glucose control and user satisfaction without compromising glycaemic stability during the adjustment period.