Six-Month Glycemic Control with a Hybrid Closed-Loop System in Type 1 Diabetes Patients during COVID-19 Pandemic in Argentina

Proietti, Adrian E.; Angós, Marcial A.; Dain, Alejandro Echenique Mariela I.; Kabakian, María L.; Paz, Maria P.; Raggio, Marcela Rubin Graciela B.; Saleme, Antonio Santucci Maria P.; Castro, Matias Daghero Andrea Grosembacher Luis A.

Background and Aims: Despite recent technological advances, optimal glycemic control remains a challenge in people with type 1 diabetes (T1D). Hybrid closed loop (HCL) systems with automated algorithm-derived adjustment of basal insulin delivery, aims to improve glycemic control without adding additional therapy burden or educational investments. Aim: To evaluate the effectiveness of HCL system in Latin American subjects with T1D and who received a completely virtual training. Methods: Prospective observational data analysis that included consecutive patients with T1D that initiated treatment with MiniMed™ 670G system in Argentina. Baseline and follow up visits at days 28, 90 and 180 were carried out and data was downloaded from Carelink™ Personal at each visit. Patient training and follow-up were performed completely virtual through video conference. Results: A total of 104 patients were included, age: 32.8 ± 17.2 (range 8-77). Subjects were previously on MDI+SMBG (26%), MDI+isCGM (12.5%), CSII+SMBG (9.6%), CSII+isCGM (2.9%), and SAP-TS (49%). Baseline GMI was 7.3 ± 0.8%. Time in range (TIR) 70-180 mg/dl significantly increased regardless of prior therapy from 62.1±14.8 % at baseline to 74.6±8.6 %, 74.2±9.8 % and 74.3±9.6 % at days 28, 90 and 180 respectively (p<0,05). Mean glucose levels decreased from 166,1mg/dL at baseline to 152.9 mg/dL (p<0,05) at day 180. GMI was also reduced from 7.3% to 6.9% (p<0,05). Sensor wear time and Auto Mode use were 89.1% and 88.6% respectively, by the end of the study. All patients completed virtual training successfully. Conclusions: Our findings confirm that the use of MiniMed™ 670 System allows patients to achieve glycemic control within recommended targets in a non-selected population in Argentina. Virtual education appears to be suitable for patient training on HCL therapy during current COVID-19 pandemic situation.