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NHS England hybrid closed loop insulin pump pilot : is there variation in different hybrid closed loop insulin pump and sensor augmented continuous glucose monitoring systems?
Jesson, A M R Saraf, S Sears, N L
Jesson, A M R
Saraf, S
Sears, N L
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Affiliation
University Hospitals Birmingham
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Publication date
2023-03-13
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Abstract
Aim
To consider the variation in results in a cohort on the NHS England Hybrid closed loop insulin pump pilot data.
Method
23 patients completed the NHS England Hybrid closed loop insulin pump pilot. Patients allocated 2 different sensor augmented insulin pump systems - Medtronic 780G & Guardian sensor or Tandem T Slim & Dexcom. Allocation to type of pump was done thus:
• Currently using Medtronic - Medtronic loan pump
• Currently using Roche/Omnipod - given choice of insulin pump
• Currently using Tandem - Dexcom added to therapy
• Pre-pilot insulin pumps used: (all with freestyle libre) Omnipod = 12; Roche = 4; Medtronic = 7; Tandem = 1. During pilot, insulin pump used: Medtronic 780G=7
Tandem = 16
Results
Medtronic: 7 patients started Medtronic pump. 6 of 7 patients connected to Medtronic carelink; all had regular reviews. HbA1c Pre pilot HbA1c 77.38mmolmol-1; 3 months HbA1c 64.57mmolmol-1; 6 months HbA1c 62.29mmolmol-1; 12 months 64.71mmolmol-1. Average carbohydrates day-1 133.2g (range 8-207g day-1)
Tandem: 11 of 16 patients downloaded regularly to Glooko at home; all had regular reviews. HbA1c pre-pilot 80.06mmolmol-1; 3 months HbA1c 60.07mmolmol-1; 6 months HbA1c 60.58mmolmol-1; 12 months HbA1c 62.26mmolmol-1. Average carbsday-1 123.4g (range 40 - 247gday-1)
Summary
In this small cohort, Tandem & Dexcom users were less compliant with downloads; entered fewer carbohydrates per day, but had a larger drop in HbA1c 17.8mmolmol-1 v 12.67mmolmol-1. Is this variation due algorithm; different target glucose in pump; consistency of use of glucose sensor; ease of settings changes in tandem; or chance? This variation deserves more investigation.
Citation
Jesson, A.M.R., Saraf, S. and Sears, N.L. (2023) 'NHS England hybrid closed loop insulin pump pilot : is there variation in different hybrid closed loop insulin pump and sensor augmented continuous glucose monitoring systems?'. Diabetes UK Annual Professional Conference. Liverpool: 26-28 April.
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Conference Output