970-P: Safety and Glucose Control with "Do It Yourself Android Artificial Pancreas System" Using Freestyle Libre Sensor + MiaoMiao in Patients with Type 1 Diabetes

Introduction & Objective: Do it yourself (DIY) Android Artificial Pancreas Systems (AAPS) integrate insulin infusion and glucose sensors at lower cost than commercial systems. Freestyle Libre™ 1 + MiaoMiao™ + insulin pump has been poorly studied for this purpose. This study aims to evaluate the effectiveness and safety of this system in patients with type 1 diabetes (T1D).

Methods: This is an observational study performed in Brazil. Patients were recruited through social media. Data was collected remotely with a questionnaire (AirTable). Non pregnant individuals with more than 3 years of T1D who used DIY AAPS were included. Continuous glucose monitoring data, quality of life (QOL) through DQOL-Brazil instrument and hemoglobin A1c (A1c) prior and after treatment were accessed.

Results: 69 patients were included, with mean age and disease duration of 36.4 ± 13.2 and 20.9 ±12.1 years, respectively. Among them, 60.9% had higher education. Mean time in range, hypoglycemia < 70 mg/dL, hypoglycemia < 54 mg/dL, hyperglycemia > 180 mg/dL, hyperglycemia > 250 mg/dL and glucose coefficient variability were 78.5% ± 16.6, 4.1% ± 3.4, 1.3% ± 1.8, 16.1% ± 11.9, 4.1% ± 5.6 and 46.3% ±16.2, respectively. Mean A1c before and after treatment were 8.9 ± 11.6 and 6.4% ± 0.7, respectively. 75.5% of patients had A1c <7%. The frequency of reported severe hypoglycemia in the past year and weekly hypoglycemia were 0.4 (±1.0) and 3.3 (± 2.2), respectively. 79.2% of the responders were very/moderately satisfied with their treatment and 64.2% were very/ moderately satisfied with time spent to manage T1D.

Conclusion: DIY AAPS with Freestyle Libre™ 1 + MiaoMiao™ seems safe and well accepted by patients with T1D in Brazil. Most users had A1c < 7% and significantly improved A1c after initiation, but percentage of time in hypoglycemia and glucose CV are still above target, which might be related to algorithm limitations, the system components or lack of proper patient education.