Introduction and Objective: The National Health Service (NHS) England hybrid closed-loop (HCL) pilot provided access to HCL for adults with type 1 diabetes (T1D), managed with an insulin pump and intermittently scanned continuous glucose monitoring, with a HbA1c ≥8.5%. We assessed the factors associated with improved diabetes-related distress (DRD) at follow up.Methods: Anonymized baseline and follow-up data were collected via a secure online tool. We performed logistic regression on variables including age, gender, ethnicity, multiple deprivation index, weight, body mass index, Gold score, HbA1c, sensor glucometrics, number of sensor scans/day, duration of diabetes and pump therapy, two-item diabetes distress score (DDS2), total daily insulin dose (TDD) and %time in HCL. Analysis was performed in SpSS v29.0.Results: Individuals (n = 298; 29 UK diabetes centres) with high DRD (DDS2 ≥3) at baseline with follow-up DDS2 data were included [72% female; 86% White; median age 37 years (IQR 28-49) and diabetes duration 20 years (IQR 14-28); baseline HbA1c 9.5 ± 0.9%]. After 9 months (IQR 6-20), DRD improved (DDS2 <3) in 205/298 (68.8%) (group A) and remained high in 93/298 (31.2%) (group B). Compared with group B, group A had lower baseline DDS2 (3.8 ± 0.8 vs 4.2 ± 0.9, p = 0.001) and TDD (48.2 ± 21.3 vs 55.3 ± 33.0, p = 0.03); no other significant between-group differences were observed. Improved DRD was inversely associated with baseline DDS2 (B=-0.726, p = 0.03) in the multivariable model, and female gender (B= -0.68, p = 0.02), baseline DDS2 (B=-0.44, p = 0.002), and TDD (B=-0.01, p = 0.04) in the univariate models. No other associations were reported.Conclusion: HCL was associated with improvements in DRD in T1D, irrespective of ethnicity, deprivation status, baseline glucose outcomes and hypoglycemia awareness. Additional therapeutic interventions are needed to further reduce DRD in HCL users.
A.L. Liarakos: Other Relationship; Dexcom, Inc. T.S. Crabtree: Other Relationship; Abbott, Dexcom, Inc., Eli Lilly and Company, Insulet Corporation. T.P. Griffin: Speaker’s Bureau; Novo Nordisk A/S, AbbVie Inc, Dexcom, Inc. Advisory Panel; Dexcom, Inc. Speaker’s Bureau; Bayer Pharmaceuticals, Inc, Eli Lilly and Company, Abbott. L. Langeland: None. I.C. Cranston: Research Support; Abbott. Speaker’s Bureau; Eli Lilly and Company, Novo Nordisk, AstraZeneca. Advisory Panel; Glooko, Inc, Roche Diabetes Care. Speaker’s Bureau; Boehringer-Ingelheim, Bayer Pharmaceuticals, Inc. Advisory Panel; Abbott. Speaker’s Bureau; Insulet Corporation. S.A.D. Mathara Diddhenipothage: None. J. Elliott: Speaker’s Bureau; Abbott. Research Support; Dexcom, Inc. Advisory Panel; Dexcom, Inc. Speaker’s Bureau; Dexcom, Inc., Boehringer-Ingelheim, Eli Lilly and Company. Advisory Panel; Glooko, Inc. Speaker’s Bureau; Insulet Corporation. Advisory Panel; Roche Diabetes Care. Speaker’s Bureau; Sanofi. Advisory Panel; Ypsomed AG. N.J. Furlong: None. J. Cardwell: None. C. Philbey: None. L. Sawyer: None. V.J. Parfitt: Other Relationship; SBK (UK) Ltd. Z.Z. Htike: None. C. Williams: Speaker’s Bureau; Abbott, Novo Nordisk. S. Kamaruddin: None. P. Kar: None. R.E. Ryder: Speaker’s Bureau; Abbott, AstraZeneca, GI Dynamics. Consultant; GI Dynamics. Other Relationship; Novo Nordisk. Speaker’s Bureau; Besins Healthcare. P. Choudhary: Speaker’s Bureau; Abbott. Advisory Panel; Dexcom, Inc. Consultant; Insulet Corporation. Advisory Panel; Ypsomed AG, embecta, Sanofi. Speaker’s Bureau; Lilly Diabetes, Medtronic. Advisory Panel; Roche Diabetes Care. Consultant; Cambridge Mechatronics. E.G. Wilmot: Research Support; Abbott. Speaker’s Bureau; Abbott. Advisory Panel; Abbott. Speaker’s Bureau; AstraZeneca. Advisory Panel; Dexcom, Inc. Speaker’s Bureau; Dexcom, Inc., Eli Lilly and Company. Advisory Panel; Eli Lilly and Company. Research Support; embecta. Advisory Panel; embecta. Research Support; Insulet Corporation. Speaker’s Bureau; Insulet Corporation. Advisory Panel; Insulet Corporation, Medtronic. Speaker’s Bureau; Novo Nordisk. Advisory Panel; Novo Nordisk. Research Support; Novo Nordisk. Advisory Panel; Roche Diabetes Care, Sanofi. Speaker’s Bureau; Sanofi. Advisory Panel; Sinocare Inc. Speaker’s Bureau; Ypsomed AG.
Association of British Clinical Diabetologists
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