Abstract：
UNASSIGNED: Clinical trials have demonstrated the efficacy and safety of hybrid closed-loop (HCL) systems, yet few studies have compared outcomes in the real-world setting.
UNASSIGNED: This retrospective study analyzed patients from an academic endocrinology practice between January 1, 2018, and November 18, 2022. The inclusion criteria were diagnosis code for type I diabetes (T1D), >18 years of age, new to any HCL system [Medtronic 670G/770G (MT), Tandem Control IQ (CIQ), or Omnipod 5 (OP5)], and availability of a pump download within three months. The outcomes included %time in range (TIR) of 70 to 180 mg/dL, %time below range (TBR) <70 mg/dL at 90 days, and HbA1c for 91 to 180 days.
UNASSIGNED: Of the 176 participants, 47 were MT, 74 CIQ, and 55 OP5. Median (25%, 75%) change in HbA1c was -0.1 (-0.8, 0.3), -0.6 (-1.1, -0.15), and -0.55 (-0.98, 0)% for MT, CIQ, and OP5, respectively, (P = .04). TIR was 70 (57, 76), 67 (59, 75), and 68 (60, 76)% (P = .95) at 90 days while TBR was 2 (1, 3), 1 (0, 2), and 1 (0, 1)%, respectively, (P = .002). The %time in automated delivery was associated with TIR and change in HbA1c. After controlling other factors including %time in automated delivery, HCL type was not an independent predictor of change in HbA1c nor TIR but remained a significant predictor of TBR.
UNASSIGNED: There were significant reductions in HbA1c in CIQ and OP5. TIR was similar across pumps, but TBR was highest with MT. The %time in automated delivery likely explains differences in change in HbA1c but not TBR between HCL systems.
UNASSIGNED: This retrospective study analyzed patients from an academic endocrinology practice between January 1, 2018, and November 18, 2022. The inclusion criteria were diagnosis code for type I diabetes (T1D), >18 years of age, new to any HCL system [Medtronic 670G/770G (MT), Tandem Control IQ (CIQ), or Omnipod 5 (OP5)], and availability of a pump download within three months. The outcomes included %time in range (TIR) of 70 to 180 mg/dL, %time below range (TBR) <70 mg/dL at 90 days, and HbA1c for 91 to 180 days.
UNASSIGNED: Of the 176 participants, 47 were MT, 74 CIQ, and 55 OP5. Median (25%, 75%) change in HbA1c was -0.1 (-0.8, 0.3), -0.6 (-1.1, -0.15), and -0.55 (-0.98, 0)% for MT, CIQ, and OP5, respectively, (P = .04). TIR was 70 (57, 76), 67 (59, 75), and 68 (60, 76)% (P = .95) at 90 days while TBR was 2 (1, 3), 1 (0, 2), and 1 (0, 1)%, respectively, (P = .002). The %time in automated delivery was associated with TIR and change in HbA1c. After controlling other factors including %time in automated delivery, HCL type was not an independent predictor of change in HbA1c nor TIR but remained a significant predictor of TBR.
UNASSIGNED: There were significant reductions in HbA1c in CIQ and OP5. TIR was similar across pumps, but TBR was highest with MT. The %time in automated delivery likely explains differences in change in HbA1c but not TBR between HCL systems.
摘要：
■临床试验证明了混合闭环（HCL）系统的有效性和安全性，然而，很少有研究比较现实世界中的结果。
■这项回顾性研究分析了2018年1月1日至2022年11月18日期间学术内分泌学实践的患者。纳入标准为I型糖尿病（T1D）的诊断代码，>18岁，任何HCL系统的新功能[美敦力670G/770G(MT)，串联控制IQ(CIQ),或Omnipod5(OP5)]，并在三个月内下载泵。结果包括70至180毫克/分升范围内的时间百分比(TIR)，在90天时低于范围（TBR）<70mg/dL的时间百分比，和HbA1c91至180天。
■在176名参与者中，47是MT，74CIQ,55OP5。中位数（25%，75%）HbA1c变化为-0.1（-0.8，0.3），-0.6(-1.1,-0.15),MT为-0.55(-0.98，0)%，CIQ,和OP5，分别（P=.04）。TIR为70（57，76），67（59，75），和68（60，76）％（P=.95）在90天，而TBR为2（1，3），1(0,2),和1(0，1)%，分别,(P=.002)。自动递送时间%与TIR和HbA1c变化相关。在控制其他因素（包括自动交付时间百分比）之后，HCL类型不是HbA1c或TIR变化的独立预测因子，但仍然是TBR的重要预测因子。
■在CIQ和OP5中HbA1c显著降低。不同泵的TIR相似，但MT的TBR最高。自动递送的%时间可能解释了HbA1c变化的差异，但不能解释HCL系统之间的TBR变化。
■这项回顾性研究分析了2018年1月1日至2022年11月18日期间学术内分泌学实践的患者。纳入标准为I型糖尿病（T1D）的诊断代码，>18岁，任何HCL系统的新功能[美敦力670G/770G(MT)，串联控制IQ(CIQ),或Omnipod5(OP5)]，并在三个月内下载泵。结果包括70至180毫克/分升范围内的时间百分比(TIR)，在90天时低于范围（TBR）<70mg/dL的时间百分比，和HbA1c91至180天。
■在176名参与者中，47是MT，74CIQ,55OP5。中位数（25%，75%）HbA1c变化为-0.1（-0.8，0.3），-0.6(-1.1,-0.15),MT为-0.55(-0.98，0)%，CIQ,和OP5，分别（P=.04）。TIR为70（57，76），67（59，75），和68（60，76）％（P=.95）在90天，而TBR为2（1，3），1(0,2),和1(0，1)%，分别,(P=.002)。自动递送时间%与TIR和HbA1c变化相关。在控制其他因素（包括自动交付时间百分比）之后，HCL类型不是HbA1c或TIR变化的独立预测因子，但仍然是TBR的重要预测因子。
■在CIQ和OP5中HbA1c显著降低。不同泵的TIR相似，但MT的TBR最高。自动递送的%时间可能解释了HbA1c变化的差异，但不能解释HCL系统之间的TBR变化。
