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This week, T1D Exchange attended the 60th European Association for the Study of Diabetes (EASD) Annual Meeting in Madrid, Spain. T1D Exchange had six presentations, and below, we’ve highlighted this research, which covers topics from CGM glucose metrics pre-and-post automated insulin delivery system use to health-related quality of life measures related to severe hypoglycemic events.
Association of CGM use with glycaemic outcomes for people with type 2 diabetes: a multi-center observational longitudinal study
This observational study investigated the relationship between continuous glucose monitor (CGM) use and A1C in people living with type 2 diabetes (T2D), regardless of insulin use.
While the value of CGM in people living with type 1 diabetes (T1D) is widely understood, the positive impacts of CGM use on glucose outcomes in T2D are becoming increasingly more evident.
By utilizing CGM data extracted from three U.S. T2D Exchange Quality Improvement Collaborative centers, the study analyzed A1C values of over 2,000 participants across five study periods (12 and 6 months before CGM use, at CGM initiation, and 6 and 12 months after CGM initiation).
Results for this diverse T2D cohort demonstrated a significant 1% reduction in A1C from 12 months before and 12 months after initiating CGM use.
Real-world total daily insulin dose in 14,358 young individuals with type 1 diabetes in the U.S.: data from the T1D Exchange Quality Improvement Collaborative
With limited data on total daily insulin usage in children and adolescents, this retrospective, observational study aimed to understand better the expected changes in insulin use with age, puberty, and weight.
By analyzing EMR data of individuals aged 2-25 years from the T1D Exchange Quality Improvement Collaborative database, we found a total daily insulin dose for the overall sample.
Results of over 14,000 individuals with T1D (with a mean age of 16.2 years) demonstrated total daily insulin dose increases from age two until peaking at puberty (earlier for females than males) and higher total daily insulin use for those on multiple daily injections (versus an insulin pump).
Researchers concluded that varied dose requirements across age groups and delivery types, along with difficulties reaching target goals (A1C results were 8.4% on average) despite using advanced technologies, suggest providers consider tailored, individual approaches to managing T1D.
CGM sensor glucose metrics pre- and post-automated insulin delivery use among adults in the T1D Exchange Online Registry
Until now, measurements in AID system-related glycemic improvements have mainly been comprised of controlled industry-conducted clinical studies. This retrospective real-world study utilized CGM data and self-reported characteristics from the T1D Exchange Online Registry from 2021-2024.
Those who met inclusion criteria (reporting pre- and post-AID system use in follow-up questionnaires with 70% CGM wear time over 14 days in the month prior to the questionnaires) amounted to 376 individuals, with a mean age of 41 years and T1D duration of 19 years.
Findings align with previous studies’ results demonstrating improved glycemic outcomes in adults with T1D who use AID systems, namely A1C values <7%, time in range >70%, and others. Moreover, participants reported fewer severe hypoglycemic events in the previous 12 months.
While significantly more individuals with T1D are meeting glucose targets, many are not. Study findings suggest that diabetes care providers should consider the use of an AID system for individuals living with T1D and provide ongoing support and care for those already using an AID system to maximize its potential benefits.
Association of type 1 diabetes duration or duration of advanced technology utilization with severe hypoglycaemic event frequency
Many adults living with T1D experience severe hypoglycemic events (SHE) or impaired awareness of hypoglycemia (IAH) regardless of using advanced diabetes technology. This study looked at the association between years of disease and continuous glucose monitoring in the frequency of SHE.
Participants from the T1D Exchange Registry completed an online survey about their experiences with SHE, IAH, CGM use, and years living with T1D. Cohorts were created based on SHE frequency over the past year and issues with IAH.
We found no significant associations between SHE, years since T1D diagnosis (mean of 29), or CGM use (55% were using ≥5 years) in the 1,847 participants. Findings suggest severe hypoglycemia remains a significant risk factor regardless of advanced technology use and years of living with the condition.
Health-related quality of life and burden of type 1 diabetes and severe hypoglycaemia in adult continuous glucose monitor users
Through this research, we aimed to understand how severe hypoglycemia events (SHE) can reduce health-related quality of life measures while increasing the human and economic burden on individuals living with T1D.
T1D Exchange Registry participants (18 years and older and CGM users) completed an online self-report survey about SHE experiences, impaired awareness of hypoglycemia (IAH), and patient-reported outcome measures. On average, participants were 49.5 years old, living with T1D for 29 years, and reported 1.8 SHEs in the past year.
Anxiety and depressive symptoms of type 1 diabetes and severe hypoglycaemia in adult continuous glucose monitor users
This study’s goal was to examine the relationship between severe hypoglycemic events (SHE) and impaired awareness of hypoglycemia (IAH) with rates of depression and anxiety in adults with T1D who use continuous glucose monitoring. We used online survey data from adults in our registry to examine the correlation between SHE and IAH, and anxiety/depression symptoms (PHQ-4).
Study results showed a higher frequency of anxiety/depression with SHE, but the same did not hold true for IAH alone. Findings suggest that more research is needed to understand this complex relationship.
