Non-commercial insulin delivery closed-loop systems: results of comparative research with traditional methods of insulin therapy

BACKGROUND: The problem of achieving target glycemic control in patients with diabetes mellitus type 1 (T1DM) remains relevant. Currently, new, more technologically advanced methods of insulin therapy (IT) are being actively developed — one of them is the IT method of a closed loop (do-it-yourself closed loop system, DIY-CLS). This type of therapy is not registered in Russia, however, patients install these systems themselves, in connection with which it seems important to discuss the principle of DIY-CLS operation, the possibilities and prospects of their use.

OBJECTIVE: To evaluate the glycemic control indicators, the frequency of acute complications of diabetes in patients with type 1 diabetes on different types of therapy.

MATERIALS AND METHODS: We observed 98 patients who were divided into 3 groups: patients using MII (n=40), patients with CSII (n=40) and patients with DIY-CLS (n=18). All groups were comparable in age, sex and the duration of T1DM history.

RESULTS: The majority of patients were women (73.47%), the average age was 33.3±2.4 years, the duration of diabetes was 17.1±2.2 years. It was found that in patients from the DIY-CLS group, compared with the MII and CSII groups, according to continuous glucose monitoring, the time in range was significantly higher, the mean glucose, standard deviation, time above range 10.1–13.9 mmol/l and time above range >13.9 mmol/l were significantly lower. The number of hypoglycemic states and hyperglycemic events leading to the development of ketosis was comparable.

CONCLUSION: Glycemic control values were significantly better in patients using DIY-CLS. Patients in the DIY-CLS group more often achieved target time above range and coefficient of variation levels.

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