Ebekozien, O, Demeterco-Berggren, C, Clements, M, Majidi, S, Malik, F, Hsieh, S, Haw, S, Kamboj, M, Noor, N.

Background and Aims: There is growing evidence that the use of hybrid closed loop systems (HCLS) is associated with a lower risk of diabetic ketoacidosis (DKA) in people with type 1 diabetes (T1D). In this study, we use real‐world data from the T1DX‐QI Electronic Medical Record database to investigate the association between HCLS use and patient‐reported DKA events using propensity score matching.

Methods: We used the T1DX‐QI EHR database to examine DKA events across propensity score‐matched HCLS users and HCLS non‐user groups. All available data for the pediatric (6 years and older) and adult population with T1D from March 2018‐March 2022 were included in this analysis (n = 8,455). Patient‐reported DKA events were defined as DKA events reported by the patient at their most recent clinic visit. They were classified as a binary variable (Yes/No), with those reporting one or more DKA events being classified under ‘Yes’. Similarly, HCLS device use was defined as the use of HCLS reported by the patient at their most recent clinic encounter. Propensity scores were estimated using a logit model, including age, gender, race/ethnicity, and insurance status as covariates. Matching was performed on propensity scores using 1:1 matching with the nearest neighbor approach and a caliper of 0.1.

Results: There were 1537 matched individuals with T1D in each HCLS user and HCLS non‐users group. Propensity score‐matched analysis showed that HCLS users were less likely than HCLS non‐users to report one or more DKA events (OR [95% CI]: 0.7 [0.5, 0.8]) when controlling for other variables.

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