Limitations in Achieving Glycemic Targets From CGM Data and Persistence of Severe Hypoglycemia in Adults With Type 1 Diabetes Regardless of Insulin Delivery Method
Lori M. Laffel, Jennifer L. Sherr, Jingwen Liu, Wendy A. Wolf, Jeoffrey Bispham, KATHERINE S.M. CHAPMAN, Daniel A. Finan, Lina Titievsky, Tina Liu, Kaitlin Hagan, Jason L. Gaglia, Keval Chandarana, Jeremy Pettus, Richard M. Bergenstal
Abstract
OBJECTIVE: We captured continuous glucose monitoring (CGM) metrics from a large online survey of adults with type 1 diabetes to determine how glycemic outcomes varied by insulin delivery form. RESEARCH DESIGN AND METHODS: Adults with type 1 diabetes from the T1D Exchange Registry/online communities completed the survey and contributed retrospective CGM data for up to 1 year. Self-reported glycemic outcomes and CGM measures were described overall and by insulin delivery method. RESULTS: The 926 participants completed the survey and provided CGM data. Mean ± SD age was 41.9 ± 15.7 years, and 50.8% reported using automated insulin delivery (AID). While AID users spent more time in range, 27.9% did not achieve time in range targets, 15.5% reported severe hypoglycemic events (SHEs), and 16.0% had CGM-detected level 2 hypoglycemic events. CONCLUSIONS: Despite use of diabetes technologies, many individuals are unable to achieve glycemic targets and experience severe hypoglycemia, highlighting the need for novel treatments.