Hybrid closed-loop systems present lower risk for severe hypoglycemia in type 1 diabetes
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People with type 1 diabetes using a hybrid closed-loop insulin delivery system are less likely to experience severe hypoglycemia than nonusers, according to study data.
“Our real-world observational study demonstrates the strong association of the use of hybrid closed-loop systems and reduced odds of severe hypoglycemia,” Osagie Ebekozien, MD, MPH, chief medical officer at T1D Exchange, and Nudrat Noor, PhD, associate director of population health at T1D Exchange, told Healio. “Other studies have demonstrated that hybrid closed-loop systems have been associated with reduced time spent in hypoglycemia and improved awareness of hypoglycemia, which among other factors can contribute to the reduced odds of severe hypoglycemia.”
Ebekozien, Noor and colleagues analyzed real-world data from the T1D Exchange’s electronic medical records database from March 2018 to March 2022. The study population included children aged 6 years and older as well as adults with type 1 diabetes. Propensity score matching was used to analyze the prevalence of severe hypoglycemia in a group of patients using a hybrid closed-loop system and a group of people who did not use a hybrid closed-loop system. Severe hypoglycemia events were self-reported by participants at their most recent clinic visit.
The findings were presented at the International Conference on Advanced Technologies & Treatments for Diabetes.
Researchers matched 1,537 people with type 1 diabetes using a hybrid closed-loop system, 1:1, with nonusers. After controlling for covariates, the hybrid closed-loop system group had a lower likelihood of reporting a severe hypoglycemia event than those in the nonusers group (adjusted OR = 0.2; 95% CI, 0.1-0.4; P < .0001). Additionally, non-Hispanic Black participants had increased odds for severe hypoglycemia compared with white participants. Ebekozien and Noor said more studies with large, diverse cohorts must be conducted to see if that disparity is replicated.
“Additional studies are needed to understand contributors and drivers to unexpected outcomes among people using hybrid closed-loop systems,” Ebekozien and Noor said. “Furthermore, it will be critical to study and test practical solutions that can provide the most support for patients.”
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Ebekozien O, et al. OP 020. Presented at: International Conference on Advanced Technologies & Treatments for Diabetes; Feb. 22-25, 2023; Berlin (hybrid meeting).
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