Long-term efficacy of sensor-augmented pump therapy (Minimed 640G system) combined with a telemedicine follow-up in patients with type 1 diabetes: A real life study

Léonie Makuété Notemi; Lamia Amoura; Fatéma Fall Mostaine; Laurent Meyer; Dominique Paris; Samy Talha; Julien Pottecher; Laurence Kessler

doi:10.1016/j.jcte.2022.100306

Long-term efficacy of sensor-augmented pump therapy (Minimed 640G system) combined with a telemedicine follow-up in patients with type 1 diabetes: A real life study

J Clin Transl Endocrinol. 2022 Oct 1:30:100306. doi: 10.1016/j.jcte.2022.100306. eCollection 2022 Dec.

Authors

Léonie Makuété Notemi¹, Lamia Amoura¹, Fatéma Fall Mostaine¹, Laurent Meyer¹, Dominique Paris¹, Samy Talha^{2

3}, Julien Pottecher⁴, Laurence Kessler^{1

5}

Affiliations

¹ Department of Endocrinology, Diabetes and Nutrition, University Hospital of Strasbourg, 1 place de l'Hôpital, 67091 Strasbourg Cedex, France.
² Department of Physiology and Functional Explorations, Pole of Thoracic Pathology, University Hospital of Strasbourg, 1 place de l'Hôpital, 67091 Strasbourg cedex, France.
³ UR 3072, « Mitochondria, Oxidative Stress and Muscle Protection », CRBS, CS 60026, 1, rue Eugène Boeckel, 67084 Strasbourg Cedex, France.
⁴ Anesthesia-intensive Care Department and Peri-Operative Medicine, Hautepierre Hospital, 1, Avenue Molière, 67098 Strasbourg Cedex, France.
⁵ INSERM UMR 1260 - Regenerative Nanomedicine, Organ Dysfunction and Transplantation, University of Strasbourg, Pharmacy Faculty 74 route du Rhin, 67401 Illkirch, France.

Abstract

Objective: Evaluate the efficacy of a new modality of insulin therapy associating both the sensor-augmented pump therapy with predictive low-glucose management (SAP-PLGM) and a telemedicine follow-up in patients with Type 1 diabetes (T1D) in a real-life setting.

Methods: T1D adults under Minimed 640G system with a telemedicine follow-up for glucose management were included in a retrospective study. The primary endpoint was HbA1c while continuous glucose monitoring parameters (CGM) and treatment compliance were the secondary endpoints. These parameters were analyzed according to the therapeutic indication, HbA1c ≥ 8 % (Group A) or severe hypoglycemic events (Group B) and in patients switched to SAP-PLGM therapy.

Results: 62 patients were analyzed with a 28 ± 12 months of follow-up. In Group A, HbA1c decreased from 8.3 ± 0.4 % to 7.7 ± 0.7 % (p < 0.05) and to 7.9 ± 0.3 % (p < 0.05) after 2 and 3 years, respectively. In patients switched to SAP-PLGM therapy, HbA1c decreased from 7.7 ± 0.7 % to 7.2 ± 0.8 % (p < 0.05) at 2 years. After 6 months, the time-below-range (<70 mg/dL) decreased from 2.1 % [0.6-4] to 1.1 % [0.3-2.6] (p < 0.05). Severe hypoglycemic events decreased from 1.62 to 0.5 events/patient/year in Group B (p < 0.05). At 3 years, treatment compliance was 92 % [70-97] in the total population.

Conclusions: Long-term real-life treatment with the SAP-PLGM therapy combined with telemedicine was associated with improved glycemic control in T1D, along with high treatment compliance.

Keywords: CRA, Clinical Research Associate; Continuous glucose monitoring; Hypoglycemia; Insulin pump therapy; Predictive low-glucose management; RN, Registered Nurse.