Improvement in Hypoglycemia Outcomes in a Pediatric Population Using Predictive Low-Glucose Suspend

Jodie M. Ambrosino,* Molly McElwee-Malloy, Stephanie Habif

Introduction

Technology is changing how type 1 diabetes (T1D) is managed. Recent T1D Exchange data indicate that use of technology has increased significantly within the last 3-4 years, particularly in children less than 12 years old. These same data indicate that even so, clinical outcomes worsened over time. Typically, hypoglycemia has been a limiting factor for the attainment of optimal outcomes, however these data demonstrated that incidence of severe hypoglycemia was significantly lower in pump users and trended in the same direction for continuous glucose monitoring (CGM) users. The t:slim X2™ insulin pump with Basal-IQ® technology integrates these two technologies and predicts glucose levels 30 minutes ahead.

Method

De-identified real-world data uploaded to the t:connect® web application (between August 31, 2018 and March 14, 2019) was retrospectively analyzed to assess hypoglycemia outcomes. as measured by continuous glucose monitoring (CGM). The overall group (OG) included 2,696 pediatric users (<18 years; mean blood glucose = 188). Of these, 491 users had sensor-augmented pump data available both pre- and post-predictive low-glucose suspend (PLGS) use.

Results

Pre-post analysis demonstrated a significant reduction in hypoglycemia. Specifically, median time <70 mg/dL decreased from 1.6% to 1.1% upon introduction of Basal-IQ technology. This represents a 31% reduction in hypoglycemia. Sensor time in range (defined as 70-180 mg/dL) remained steady between pre- and post-use of Basal-IQ technology. However, there was a significant decrease in sensor glucose values >300 mg/dL.

Conclusion

Real-world use of Basal-IQ technology is associated with significant reductions in hypoglycemia for pediatric patients. High system reliability and infrequent user overrides reflect high user trust and user comfort with Basal-IQ technology.