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Introduction <p>Advanced hybrid closed-loop (AHCL) systems have shown promise in improving glycemic control in adults with type 1 diabetes (T1D), yet real-world evidence remains limited. This study evaluated the impact of transitioning from multiple daily injections (MDI) or conventional continuous subcutaneous insulin infusion (CSII) to the Tandem t:slim X2™ Control-IQ® AHCL system on glycemic outcomes in adults with T1D.</p> Methods <p>In this retrospective study, 56 non-pregnant adults with T1D were followed for 6 months. Primary outcomes were changes in the Glycemia Risk Index (GRI) and percentage time in the tight range (%TiTR<sub>70-140</sub>). Secondary outcomes included other standardized ambulatory glucose profile metrics as well as additional glycemic, anthropometric, and insulin dosing measures.</p> Results <p>Transition to the Control-IQ system increased %TiTR<sub>70-140</sub> by 11.5 percentage points and reduced GRI by 23.5 points. Both components of the GRI, hypoglycemia risk (%Chypo) and hyperglycemia risk (%Chyper), improved significantly. Hemoglobin A1c decreased by 1.0%, time in range (%TIR<sub>70-180</sub>) improved by 13.6 percentage points, and glycemic variability (CV%) showed marked improvement. Total daily insulin dose decreased by 34%, accompanied by modest weight loss. No diabetic ketoacidosis episodes were reported throughout the study period.</p> Conclusion <p>Transitioning to the Tandem t:slim X2 Control-IQ AHCL system led to significant improvements in tight glycemic control, glycemic risk reduction, and insulin efficiency, with a favorable safety profile. These findings support broader adoption of AHCL technology and underscore the need for prospective multicenter studies.</p>

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Evaluation of Glycemia Risk Index and Continuous Glucose Monitoring Outcomes Following the Transition to an Advanced Hybrid Closed-Loop System in Type 1 Diabetes

  • 期刊论文

  • 发表日期：

    2025年8月6日

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  • Ayman Al Hayek,
  • Wael M. Alzahrani,
  • Abdulghani H. Al Saeed,
  • Malak Al Mashali,
  • David C. Klonoff,
  • Mohamed A. Al Dawish

摘要

Introduction

Advanced hybrid closed-loop (AHCL) systems have shown promise in improving glycemic control in adults with type 1 diabetes (T1D), yet real-world evidence remains limited. This study evaluated the impact of transitioning from multiple daily injections (MDI) or conventional continuous subcutaneous insulin infusion (CSII) to the Tandem t:slim X2™ Control-IQ® AHCL system on glycemic outcomes in adults with T1D.

Methods

In this retrospective study, 56 non-pregnant adults with T1D were followed for 6 months. Primary outcomes were changes in the Glycemia Risk Index (GRI) and percentage time in the tight range (%TiTR70-140). Secondary outcomes included other standardized ambulatory glucose profile metrics as well as additional glycemic, anthropometric, and insulin dosing measures.

Results

Transition to the Control-IQ system increased %TiTR70-140 by 11.5 percentage points and reduced GRI by 23.5 points. Both components of the GRI, hypoglycemia risk (%Chypo) and hyperglycemia risk (%Chyper), improved significantly. Hemoglobin A1c decreased by 1.0%, time in range (%TIR70-180) improved by 13.6 percentage points, and glycemic variability (CV%) showed marked improvement. Total daily insulin dose decreased by 34%, accompanied by modest weight loss. No diabetic ketoacidosis episodes were reported throughout the study period.

Conclusion

Transitioning to the Tandem t:slim X2 Control-IQ AHCL system led to significant improvements in tight glycemic control, glycemic risk reduction, and insulin efficiency, with a favorable safety profile. These findings support broader adoption of AHCL technology and underscore the need for prospective multicenter studies.