Glycaemic control in insulin deficient patients using different insulin delivery and glucose sensoring devices: Cross-sectional real-life study

Aims: To assess glycaemic control in ≥15-year-old patients with type 1 diabetes treated in Tampere University Hospital in a real-life cross-sectional registry study. Methods: Glycaemic control was assessed with HbA1c, time in range (TIR) and the incidence of acute complications. The effect of age, BMI, gender, duration of diabetes, daily insulin dose, and device group on the glycaemic control was studied. Results: The study included 1,132 patients. Eighty-four percent of the patients had TIR≤70%. Two percent of patients had an episode of diabetic ketoacidosis and 0,2% had severe hypoglycemia within the last 12 months. Intermittently scanned CGM (IsCGM) with MDI was used in 59%, continuous subcutaneous insulin infusion (CSII) with glucose sensor in 15%, and sensor-augmented/hybrid closed-loop pump (SAP/HCL) in 9% of the patients. In the logistic regression analysis, TIR≤70% was associated with young age group (OR 2.70; 95% CI 1.43–5.09) and daily insulin dose per weight (OR 6.66; 95% CI 3.53–12.57). CSII with glucose sensor and IsCGM with MDI were associated with poor glycaemic control compared to SAP/HCL. Conclusion: There is room for improvement in the glycaemic control in our area although serious acute complications are rare. Closed insulin pump system was more effective than open system.