Hypoglycaemia incidence and recovery during home use of hybrid closed-loop insulin delivery in adults with type 1 diabetes.

Abstract

Introduction Glucose excursion were assessed prior and post hypoglycaemia to increase understanding of hypoglycaemia incidence and recovery during hybrid closed-loop insulin delivery. Methods We retrospectively analysed data from 60 adults with type 1 diabetes who received in crossover randomised design day-and-night hybrid closed-loop insulin delivery and insulin pump therapy, the latter with or without real-time continuous glucose monitoring. Over 4 week study periods, we identified hypoglycaemic episodes defined as sensor glucose < 3.0mmol/l analysed sensor glucose relative to the onset of hypoglycaemia. Results We identified 377 hypoglycaemic episodes during hybrid closed-loop versus 662 during control intervention (P<0.001) with a predominant reduction of nocturnal hypoglycaemia. The slope of sensor glucose prior to hypoglycaemia was steeper during closed-loop than during control intervention (P<0.01), while insulin delivery was reduced (P<0.01). During both daytime and night-time, participants recovered from hypoglycaemia faster when treated by closed-loop. At 120 min post-hypoglycaemia, sensor glucose levels were higher during closed-loop compared to control period (P<0.05). Conclusions Closed-loop reduces the risk of hypoglycaemia particularly overnight with swift recovery from hypoglycaemia leading to higher 2-hour post-hypoglycaemia glucose levels.