Original Research
Saturday, November 11, 2023
11:30 AM–01:00 PM
Abstract
Introduction: Advancements in technology have opened doors for effective treatment of patients with diabetes. Literature shows that use of insulin pumps (IP) and continuous glucose monitors (CGMs) lead to improvements in glycemic control and hypoglycemic events as compared to multiple daily injections.
Research Question or Hypothesis: The primary objective was to determine factors associated with clinical success, defined as A1C goal attainment and Time in Range (TIR) for diabetic patients using IP systems. Secondary objectives were to determine factors significantly associated with lesser time in very high and very low glucose ranges.
Study Design: Retrospective, observational, cohort study.
Methods: Patients were identified from three primary care offices between the years of 2015 to 2021. Patients were analyzed from the most recent 12 months of IP utilization. Data was retrospectively extracted from charts and cloud-based manufacturer websites that housed IP and CGM data. Univariate analyses identified variables with statistical trend (P<0.1) for the primary and secondary outcomes. Variables demonstrating trend were integrated into backward stepwise multivariate regression analyses to create a final model of significant predictors using Minitab statistical software.
Results: Predictors of A1C goal attainment were found to be use of a closed-loop system (P=0.021) and greater time in automode/Control-IQ % (P=0.011). Predictors of TIR included lower baseline A1C (P=0.018) and commercial insurance coverage (P=0.031). Predictors of reduced time in Very High CGM range included baseline A1C (p<0.001) and longer use of IP (P=0.002). Predictors of reduced time in Very Low CGM range included greater time CGM worn (P=0.004) and Type 1 Diabetes (P=0.006).
Conclusion: In patients using IP, the use of closed loop system and greater percentage time in automode/Control-IQ were associated with greater A1C goal attainment. Lower baseline A1C and commercial insurance coverage was associated with improved TIR. Longer use of IP was associated with fewer high excursions and greater time wearing CGM with fewer low excursions.
Presenting Author
Nicole Albanese Pharm.D., CDCES, BCACPUniversity at Buffalo
Authors
Christopher Brighton PharmD
Buffalo Medical Group
Scott Monte Pharm.D.
University at Buffalo, School of Pharmacy and Pharmaceutical Sciences