Introduction & Objective: In Ontario, Canada there are strict guidelines for those with type 1 diabetes (T1D) to qualify for insulin pump therapy. This often excludes those with significant glycemic variability, mixed adherence and difficulties with carbohydrate counting. However, with automated insulin delivery (AID), there are less managerial steps, making insulin-pump management easier, with improved results given algorithmic insulin modifications. Given this, this historically ignored population, would be most ideal for AID access.
Methods: This qualitative and quantitative trial identified four patients with historically difficult to manage diabetes and placed them on a nine-week trial of Dexcom G6 sensor, and six weeks on Tandem Control-IQ. They were given a pre- and post-survey and followed every 2 weeks to evaluate time in range (TIR), hypoglycemia, and assess quality of life.
Results: There were N=4 patients, 2 male, duration of diabetes 2-20 years, HbA1c (9.5-11%), pre-trial TIR 20-50%, pre-trial hypoglycemia <1%. Post-trial, A1c (7.3-8.6%), end-trial TIR 46-67%, and post-trial hypoglycemia <2%. Post-survey, comments included “Having the ability to feel more ‘normal’ having access to my sugars all the time without having to finger prick or scan⋯” “I didn’t have to think too much other than carb counting⋯” “Being able to have insulin all the time without giving a needle is great.”
Conclusion: This study demonstrates that the advancement in AID should enable a policy change to allow ubiquitous usage to those with T1D for best standard of care.
C. Ibrahim: None.
