Thread by @danamlewis

THREAD:

Poster 988-P at #ADA2020 by Jennifer Zabinsky, Haley Howell, Alireza Ghezavati, @DanaMLewis Andrew Nguyen, and Jenise Wong: “Do-It-Yourself Artificial Pancreas Systems Reduce Hyperglycemia Without Increasing Hypoglycemia”

(PDF available at bit.ly/DanaMLewisADA2…)

This was a retrospective double cohort study that evaluated data from the @OpenAPS Data Commons (data ranged from 2017-2019) and compared it to conventional sensor-augmented pump (SAP) therapy from the @Tidepool_org Big Data Donation Project. #ADA2020

One month of CGM data (with more than 70% of the month spent using CGM), as long as they were >1 year of living with T1D, was used from the @OpenAPS Data Commons. People could be using any type of DIYAPS (OpenAPS, Loop, or AndroidAPS) and there were no age restrictions. #ADA2020

A random age-matched sample from the @Tidepool_org Big Data Donation Project of people with type 1 diabetes with SAP was selected. #ADA2020

The primary outcome was percent of CGM data <70mg/dL. The secondary outcomes were no. of hypoglycemic events per month (15min or more <70mg/dL); percent of time in range (70-180mg/dL); percent of time above range (>180mg/dL), mean CGM values, coefficient of variation. #ADA2020

Table 1 shows the age of participants was not statistically different between the DIYAPS and SAP cohorts. Similarly, the age at T1D diagnosis or time since T1D diagnosis did not differ. #ADA2020

Table 2 shows additional characteristics of the DIYAPS cohort, which included data shared by a parent/caregiver for their child with T1D. DIYAPS use was an average of 7 months, for the month of CGM data used for the study. The self-reported HbA1c in DIYAPS was 6.4%. #ADA2020

Results:

Figure 1 shows the comparison in outcomes based on CGM data between the two groups. Asterisks (*) indicate statistical significance. There was no statistically significant difference in % of CGM values below 70mg/dL between the groups in this data set sampled. #ADA2020

DIYAPS users had higher percent in target range and lower percent in hyperglycemic range, compared to the SAP users. #ADA2020

Table 3 shows secondary outcomes: no statistically significant difference in average number of hypoglycemic events per month between the groups. The mean CGM glucose value was lower for the DIYAPS group, but the coefficient of variation did not differ between groups. #ADA2020

Conclusions:

Users of DIYAPS (from the sampled data) had comparable amount of hypoglycemia to SAP.

Mean CGM glucose, frequency of hyperglycemia were lower in DIYAPS group.

Percent of CGM values in target range (70-180mg/dL) was significantly greater for DIYAPS. #ADA2020

This study shows a benefit in DIYAPS in reducing hyperglycemia without compromising a low occurrence of hypoglycemia, when compared to traditional sensor-augmented pump therapy. #ADA2020

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