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OBJECTIVE: Assess the safety and efficacy of automated insulin delivery (AID) in adults with type 1 diabetes (T1D) at high risk for hypoglycemia. RESEARCH DESIGN AND METHODS: Participants were 72 adults with T1D who used an insulin pump with Clarke Hypoglycemia Perception Awareness scale score >3 and/or had severe hypoglycemia during the previous 6 months confirmed by time below range (TBR; defined as sensor glucose [SG] reading <70 mg/dL) of at least 5% during 2 weeks of blinded continuous glucose monitoring (CGM). Parallel-arm, randomized trial (2:1) of AID (Tandem t:slim ×2 with Control-IQ technology) versus CGM and pump therapy for 12 weeks. The primary outcome was TBR change from baseline. Secondary outcomes included time in target range (TIR; 70–180 mg/dL), time above range (TAR), mean SG reading, and time with glucose level <54 mg/dL. An optional 12-week extension with AID was offered to all participants. RESULTS: Compared with the sensor and pump (S&P), AID resulted in significant reduction of TBR by −3.7% (95% CI −4.8, −2.6), P < 0.001; an 8.6% increase in TIR (95% CI 5.2, 12.1), P < 0.001; and a −5.3% decrease in TAR (95% CI −87.7, −1.8), P = 0.004. Mean SG reading remained similar in the AID and S&P groups. During the 12-week extension, the effects of AID were sustained in the AID group and reproduced in the S&P group. Two severe hypoglycemic episodes occurred using AID. CONCLUSIONS: In adults with T1D at high risk for hypoglycemia, AID reduced the risk for hypoglycemia more than twofold, as quantified by TBR, while improving TIR and reducing hyperglycemia. Hence, AID is strongly recommended for this specific population. [ABSTRACT FROM AUTHOR]

This retrospective, real-world, chart review study determined the effectiveness of the FreeStyle Libre Flash Glucose Monitoring SystemTM on HbA1c when used by adults with type 2 diabetes (T2DM) as their standard of care in a real-world setting for between 3 months to 6 months. The study population included adults on a basal-bolus insulin regimen for at least 1 year, with HbA1c between 8.0 and 12.0% (64 to 108 mmol/mol), who had been prescribed and using FreeStyle Libre regularly for at least 3 months. Pregnant patients were excluded, as were patients on dialysis. A total of 88 records from insulin using patients with T2DM from 6 hospital sites in France were included in this chart review. On average, HbA1c was 9.0±0.9% (74.7±9.7 mmol/mol), prior to FreeStyle Libre use, age was 64.4±10.6 years, BMI was 32.9±5.5 kg/m2 and average duration of insulin use 9.9±6.4 years (mean±SD), 24.1% were CSII users, 58.0% of patients were on oral antidiabetic medications (metformin, SU or DPP-4) in addition to basal-bolus and 56.8% were male. CVD, renal and retinopathy complications were reported by 40.9%, 37.5% and 37.5% of patients, respectively. HbA1c results were recorded between 91 to 183 days from the start of use of FreeStyle Libre, between May 2017 and July 2018. To minimise selection bias records were selected on a systematic basis. After at least 3 months of using FreeStyle Libre, HbA1c (primary outcome) was significantly reduced by 0.8±1.1% (mean±SD); p<0.0001. Sub-group analysis by insulin administration method showed HbA1c significantly reduced for both people using multiple daily injections and CSII; with reductions of 0.7±1.1%, p<0.0001 and 1.0±1.0% (mean±SD), p=0.0001, respectively. This real-world, chart review study concluded that people with T2DM on insulin therapy, using FreeStyle Libre for between 3 to 6 months significantly reduced HbA1c. Disclosure: H. Hanaire: Research Support; Self; Abbott, Eli Lilly and Company, LifeScan, Inc., Novo Nordisk A/S. Other Relationship; Self; Eli Lilly and Company, Novo Nordisk A/S. P.Y. Benhamou: Board Member; Self; Eli Lilly and Company, Novo Nordisk Inc., Sanofi. Consultant; Self; Abbott. C. Bures: Employee; Self; Abbott Laboratories. Employee; Spouse/Partner; Alere Inc. S. Favre: None. S. Fendri: None. M. Joubert: Board Member; Self; Abbott, Air Liquide, AstraZeneca, Lilly Diabetes, Medtronic, Novo Nordisk A/S. Consultant; Self; Voluntis France. Research Support; Self; Boehringer Ingelheim International GmbH. Speaker's Bureau; Self; Amgen Inc., LifeScan, Inc., Merck Sharp & Dohme Corp., Sanofi. [ABSTRACT FROM AUTHOR]