1. Improved technology satisfaction and sleep quality with Medtronic MiniMed® Advanced Hybrid Closed-Loop delivery compared to predictive low glucose suspend in people with Type 1 Diabetes in a randomized crossover trial
- Author
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Olivia J. Collyns, Martin de Bock, Natalie Kurtz, Benjamin J Wheeler, Carla M. Frewen, Shirley Jones, Zara L. Betts, Anirban Roy, Renee A. Meier, Denis S.H. Chan, Barbara C. Galland, John H. Shin, Niranjala M. Hewapathirana, Benyamin Grosman, Robert A. Vigersky, and Chris Frampton
- Subjects
Type 1 diabetes ,medicine.medical_specialty ,Sleep quality ,business.industry ,Endocrinology, Diabetes and Metabolism ,General Medicine ,medicine.disease ,Crossover study ,Endocrinology ,Quality of life ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Low glucose suspend ,business ,Closed loop ,Glycemic - Abstract
Automated insulin delivery aims to lower treatment burden and improve quality of life as well as glycemic outcomes. We present sub-study data from a dual-center, randomized, open-label, two-sequence crossover study in automated insulin delivery naive users, comparing Medtronic MiniMed® Advanced Hybrid Closed-Loop (AHCL) to Sensor Augmented Pump therapy with Predictive Low Glucose Management (SAP + PLGM). At the end of each 4-week intervention, impacts on quality of life, sleep and treatment satisfaction were compared using seven age-appropriate validated questionnaires given to patients or caregivers. 59/60 people completed the study (mean age 23.3 ± 14.4yrs). Statistically significant differences favoring AHCL were demonstrated in several scales (data shown as mean ± SE). In adults (≥ 18yrs), technology satisfaction favored AHCL over PLGM as shown by a higher score in the DTSQs during AHCL (n = 28) vs SAP + PLGM (n = 29) (30.9 ± 0.7 vs 27.9 ± 0.7, p = 0.004) and DTSQc AHCL (n = 29) vs SAP + PLGM (n = 30) (11.7 ± 0.9 vs 9.2 ± 0.8, p = 0.032). Adolescents (aged 13–17yrs) also showed a higher DTSQc score during AHCL (n = 16) versus SAP + PLGM (n = 15) (14.8 ± 0.7 vs 12.1 ± 0.8, p = 0.024). The DTQ “change” score (n = 59) favored AHCL over SAP + PLGM (3.5 ± 0.0 vs 3.3 ± 0.0, p 16 years (n = 36) and demonstrated improved sleep quality during AHCL vs SAP + PLGM (4.8 ± 0.3 vs 5.7 ± 0.3, p = 0.048) with a total score > 5 indicating poor quality sleep. These data suggest that AHCL compared to SAP + PLGM mode has the potential to increase treatment satisfaction and improve subjective sleep quality in adolescents and adults with T1D.
- Published
- 2021