Diabetes care · 2025
Additive Benefits of Control-IQ+ AID to GLP-1 Receptor Agonist Use in Adults With Type 2 Diabetes.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Graham Timothy E, Raghinaru Dan, Afreen Samina, Ahmann Andrew, Haidar Ahmad, Raskin Philip, Tsoukas Michael A, Lum John W, Sasson-Katchalski Ravid, Pinsker Jordan E, Beck Roy W, 2IQP Study Group*
Аннотация
OBJECTIVE: To assess the effect of automated insulin delivery (AID) on glycemic and insulin outcomes in adults with insulin-treated type 2 diabetes using a glucagon-like peptide-1 receptor agonist (GLP-1 RA).
RESEARCH DESIGN AND METHODS: In a randomized trial comparing Control-IQ+ AID versus continuation of prestudy insulin delivery method plus continuous glucose monitoring (CGM group), 143 (45%) of the 319 participants were using a GLP-1 RA at baseline, which was continued during the trial.
RESULTS: Among GLP-1 RA users, mean HbA1c decreased by 0.8% from a baseline of 8.0 ± 1.2% with AID, which represented a mean improvement of -0.5% (95% CI -0.8 to -0.3, P < 0.001) compared with the CGM group. Time-in-range 70-180 mg/dL and other CGM metrics reflective of hyperglycemia also showed comparable statistically significant improvements using AID when added to GLP-1 RA use. For GLP-1 RA users, there was no significant difference in weight after 13 weeks with AID compared with the CGM group (0.9 kg, 95% CI -0.2 to 2.1, P = 0.10), whereas, in GLP-1 RA nonusers, there was a mean weight gain of 1.9 kg with AID compared with CGM (95% CI 0.5 to 3.2, P = 0.007).
CONCLUSIONS: The benefits of AID appear to be substantial for a broad spectrum of insulin-treated patients with type 2 diabetes, including those already receiving contemporary and guideline-directed therapy, such as a GLP-1 RA medication. These additive benefits of AID in GLP-1 RA users included significant reductions in HbA1c levels with simultaneous reduction in insulin use, along with no statistical increase in weight despite very significant improvements in glycemic control.
RESEARCH DESIGN AND METHODS: In a randomized trial comparing Control-IQ+ AID versus continuation of prestudy insulin delivery method plus continuous glucose monitoring (CGM group), 143 (45%) of the 319 participants were using a GLP-1 RA at baseline, which was continued during the trial.
RESULTS: Among GLP-1 RA users, mean HbA1c decreased by 0.8% from a baseline of 8.0 ± 1.2% with AID, which represented a mean improvement of -0.5% (95% CI -0.8 to -0.3, P < 0.001) compared with the CGM group. Time-in-range 70-180 mg/dL and other CGM metrics reflective of hyperglycemia also showed comparable statistically significant improvements using AID when added to GLP-1 RA use. For GLP-1 RA users, there was no significant difference in weight after 13 weeks with AID compared with the CGM group (0.9 kg, 95% CI -0.2 to 2.1, P = 0.10), whereas, in GLP-1 RA nonusers, there was a mean weight gain of 1.9 kg with AID compared with CGM (95% CI 0.5 to 3.2, P = 0.007).
CONCLUSIONS: The benefits of AID appear to be substantial for a broad spectrum of insulin-treated patients with type 2 diabetes, including those already receiving contemporary and guideline-directed therapy, such as a GLP-1 RA medication. These additive benefits of AID in GLP-1 RA users included significant reductions in HbA1c levels with simultaneous reduction in insulin use, along with no statistical increase in weight despite very significant improvements in glycemic control.