Predictive Low Glucose Suspend Algorithm in Real Life: A Five-Year Follow-Up Retrospective Analysis

Aim: Sensor-augmented pumps with predictive low glucose suspend function (PLGS-SAP) help patients avoid hypoglycemia and improve quality of life: in this retrospective study, we investigated long-term effects of PLGS-SAP on metabolic outcomes, acute and chronic diabetic complications, in particular cardiovascular events. Materials and Methods: One hundred thirty-nine adults with type 1 diabetes (T1D) treated for more than 10 years with continuous subcutaneous insulin infusion (CSII) were followed for 5 years; 71 (Group 1) started to use PLGS-SAP, and 68 (Group 2) maintained on their non-PLGM insulin pump. Glucose control measures (hemoglobin A1c [HbA1c], acute diabetic complications), clinical outcomes (body mass index [BMI], arterial hypertension, dyslipidemia), chronic diabetes-related complications, and device utilization (continuous glucose monitoring utilization, use of temporary basal rates or special boluses, carbohydrate counting usage) were assessed. Results: The reduction of HbA1c was significant in Group 1 (from 7.5% +/- 1.1% to 7.0% +/- 1.0%, P =.02), while in Group 2 it did not reach statistical significance (from 7.5% +/- 1.1% to 7.4% +/- 0.9%, P =.853). BMI increased significantly in Group 2 (from 25.3 +/- 2.8 to 25.7 +/- 3.4, P <.001), but not in Group 1 (from 25.2 +/- 3.5 to 25.2 +/- 2.8, P =.887). There were no statistically significant differences in occurrence of acute diabetes complications, other clinical outcomes, prevalence of diabetes-related complications, or device utilization between the groups. Conclusions: In our five-year follow-up experience with T1D CSII users, PLGS-SAP has resulted efficient in improving metabolic control and maintaining the body weight.