Article
Author: Tabb, Courtney ; Brown, Sue A. ; Joseph, Hal ; Mulvey, Suzanne ; Renard, Eric ; Bloks, Tanner ; Hami, Redhouane ; Fimbel, Sylvie Villar ; Thorsell, Ashley ; Rosas, Krizia ; Huyett, Lauren M ; Wodetzki, Darya ; Guevara, Evelyn ; Julia, Jean Baptiste ; Beatson, Christie ; Maxson, Amanda ; Blanscet, Hannah ; Walker, Sonya ; Herndon, Christopher ; Kravarusic, Jelena ; Penfornis, Alfred ; Qamar, Lubna ; Turcotte, Christine ; Bellili, Djamila ; Goroza, Evelyn ; Ly, Trang T. ; Aleppo, Grazia ; Beltran, Stephanie ; Isganaitis, Elvira ; Downs, Ashleigh ; Ryan, Terri ; Riveline, Jean-Pierre ; Kollar, Laura ; Weinstock, Ruth S. ; Wilby, Cate ; Christie, Kalicia ; Penn, Samsam ; Shoemaker, Ryan ; Doolan, Jade ; Dunn, Ethan ; Reed, Dajah ; Petit, Catherine ; Castorino, Kristin ; Lewis, Monica ; Stone, Sheri L. ; Ambler-Osborn, Louise ; Ownby, Jonathan ; Shelton, Nina ; Norlander, Lisa ; Salhin, Amna ; Mandava, Patali ; Stumpf, Meaghan ; Villard, Orianne ; Kipnes, Mark S. ; Laffel, Lori M. ; Thivolet, Charles ; Dumais, Bonnie ; Shah, Viral N. ; Masri, Manal Al ; Oliveri, Mary ; Potier, Charline ; Oliver, Danielle ; Hsu, Liana ; Herrmann, Stefanie ; Hirchak, Chad ; Gautier, Jean-François ; Pour, Fatemeh Movaghari ; Church, Mei Mei ; Fuller, Morgan ; Vidal-Trecan, Tiphaine ; Farret, Anne ; Hughes, Michael ; Hirsch, Irl B. ; Volkening, Lisa ; Lal, Rayhan A. ; Hernandez, Joann ; Dong, Xiaofu ; Kingman, Ryan ; Vienneau, Todd ; Conroy, Lindsey R. ; Siadoua, Marcelle ; Malik, Faisal ; Suh, Bailey ; Bzdick, Suzan ; Alix, Carlene ; Averkiou, Xenia ; Moore, Alexis ; Kivilaid, Kaisa ; Ramon, Vanessa ; Johnson, Joseph ; Akturk, Halis Kaan ; Buckingham, Bruce A. ; Bode, Bruce W.
OBJECTIVETo examine the efficacy and safety of the tubeless Omnipod 5 automated insulin delivery (AID) system compared with pump therapy with a continuous glucose monitor (CGM) in adults with type 1 diabetes with suboptimal glycemic outcomes.RESEARCH DESIGN AND METHODSIn this 13-week multicenter, parallel-group, randomized controlled trial performed in the U.S. and France, adults aged 18–70 years with type 1 diabetes and HbA1c 7–11% (53–97 mmol/mol) were randomly assigned (2:1) to intervention (tubeless AID) or control (pump therapy with CGM) following a 2-week standard therapy period. The primary outcome was a treatment group comparison of time in range (TIR) (70–180 mg/dL) during the trial period.RESULTSA total of 194 participants were randomized, with 132 assigned to the intervention and 62 to the control. TIR during the trial was 4.2h/day higher in the intervention compared with the control group (mean difference 17.5% [95% CI 14.0%, 21.1%]; P < 0.0001). The intervention group had a greater reduction in HbA1c from baseline compared with the control group (mean ± SD −1.24 ± 0.75% [−13.6 ± 8.2 mmol/mol] vs. −0.68 ± 0.93% [−7.4 ± 10.2 mmol/mol], respectively; P < 0.0001), accompanied by a significantly lower time <70 mg/dL (1.18 ± 0.86% vs. 1.75 ± 1.68%; P = 0.005) and >180 mg/dL (37.6 ± 11.4% vs. 54.5 ± 15.4%; P < 0.0001). All primary and secondary outcomes were met. No instances of diabetes-related ketoacidosis or severe hypoglycemia occurred in the intervention group.CONCLUSIONSUse of the tubeless AID system led to improved glycemic outcomes compared with pump therapy with CGM among adults with type 1 diabetes, underscoring the clinical benefit of AID and bolstering recommendations to establish AID systems as preferred therapy for this population.