The predictive low glucose suspend (PLGS) algorithm of the t:slimx2 insulin pump with Basal-IQ technology, which is used with the Dexcom G6 continuous glucose monitor (CGM), has been shown to reduce hypoglycemia, though the effect on glucose variability longitudinally in a real-world pediatric population is unknown.
We hypothesized that children and adolescents who obtain their care at an urban, academic diabetes center and use the PLGS algorithm would have improved glycemic outcomes, compared to their previous method of diabetes care.
We recruited pediatric patients aged 6-18 years old with T1D for >1 year prior to starting the PLGS system. At baseline, glycemic control was assessed using CGM or fingerstick glucose metrics. For the 3 month timepoint, Tandem T:connect software was used.
Of the 97 pediatric patients at our center with T1D for >1 year using the PLGS system, 41 pediatric subjects (51.2% female) with a median age of 13.6 years (range 6.6-17.8) and 3 month follow-up data were eligible for analysis. Baseline CSII and CGM use were 87.8% and 92.7%, respectively. Subjects were using Basal-IQ for a median of 92% of the time with 6 suspensions per day in the 2 weeks prior to 3 month follow-up. HbA1c, mean glucose, and percent time in range improved from 7.5%, 186 mg/dl and 51.9% on their previous diabetes care to 7.35%, 171 mg/dl and 57% after 3 months of Basal-IQ use (p= 0.005, p=0.03 and p=0.001). Percent time glucose below 55 mg/dl was a median of 0% at baseline and also at follow-up. There were no significant differences in coefficient of variation, percent time glucose below 70 mg/dl, and percent time glucose above 180 mg/dl. There were also no episodes of DKA or severe hypoglycemia after initiation of Basal-IQ in this cohort.
The t:slim x2 insulin pump with Basal-IQ technology resulted in improved HbA1c, mean glucose, and percent time in range in pediatric patients after 3 months of use, without an increase in hypoglycemia or adverse events. 6 month data is being analyzed.
A. Weiner: None. E. Robinson: None. R. Gandica: None.
National Institutes of Health (T32DK065522-14)