Closed Loop Control (CLC) has the ability to reduce both hypoglycemia and hyperglycemia. We conducted a post-hoc analysis of data from the iDCL DCLP3 randomized trial comparing CLC with Control-IQ versus sensor augmented pump therapy (SAP) for 6 months in participants who had baseline CGM below 70mg/dL ≥4.0% of the time (N= 41 CLC, 14 SAP, mean±SD age of 33±16yrs, 49% female). CLC use led to a greater reduction in time below 70mg/dL (least square mean change from baseline of -4.6% in CLC vs. -3.1% in SAP, mean-adjusted treatment difference -1.5% or 22 min/d, 95% CI -2.2% to -0.9%, P<0.0001), increased time in range 70-180 mg/dL (mean-adjusted difference +10.4% or 2.5 hr/d, P<0.0001), decreased time above 180mg/dL (mean-adjusted difference -8.5% or 2.0 hr/d, P=0.0001), decreased mean glucose (mean-adjusted difference -10.4 mg/dL, P=0.005), and lower HbA1C (mean-adjusted difference -0.28%, P=0.06). CLC improves HbA1C and reduces both hypoglycemia and hyperglycemia in people with T1D with elevated levels of hypoglycemia prior to starting CLC.

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Disclosure

C.J. Levy: Consultant; Self; Dexcom, Inc. Employee; Spouse/Partner; Allergan plc. Research Support; Self; Abbott, Dexcom, Inc., Insulet Corporation. G. O’Malley: Research Support; Self; Abbott, Dexcom, Inc. S.A. Brown: Research Support; Self; Dexcom, Inc., Insulet Corporation, Roche Diabetes Care, Tandem Diabetes Care, Tolerion, Inc. G.P. Forlenza: Advisory Panel; Self; Medtronic. Consultant; Self; Dexcom, Inc., Insulet Corporation, Tandem Diabetes Care. Research Support; Self; Abbott, Dexcom, Inc., Insulet Corporation, Medtronic, Tandem Diabetes Care. Y.C. Kudva: Research Support; Self; Dexcom, Inc., Roche Diabetes Care. Other Relationship; Self; Abbott. R. Beck: None. C. Kollman: Other Relationship; Self; Dexcom, Inc., Tandem Diabetes Care. J. Lum: None. D. Raghinaru: None. B. Kovatchev: Advisory Panel; Self; Dexcom, Inc. Research Support; Self; Dexcom, Inc., Tandem Diabetes Care. Speaker’s Bureau; Self; Dexcom, Inc., Sanofi, Tandem Diabetes Care. Other Relationship; Self; Dexcom, Inc., Johnson & Johnson, Sanofi.

Funding

National Institute of Diabetes and Digestive and Kidney Diseases (UC4108483); University of Virginia Strategic Investment Fund (Project 88); Tandem Diabetes Care

© 2020 by the American Diabetes Association
2020
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