Role of automated insulin delivery (AID) systems in glucose control in patients with diabetes mellitus undergoing dialysis in Calabria: AID-DIAL-CAL

Aims: To describe the main glycemic outcomes and the Quality of Life (QOL) observed in a cohort of people with type 1 (T1D) or type 2 (T2D) insulin-treated diabetes under dialysis who started an Automated Insulin Delivery (AID) system. Methods: This is a longitudinal retrospective pilot real-world analysis of 14 individuals with T1D and T2D undergoing dialysis who began using an AID system to optimize glycemic control. All subjects used the MiniMed™ 780G system. Glucose metrics were collected at baseline, 3, 6, and 12 months after initiating the SmartGuard™ feature. The WHOQoL-Bref questionnaire was administered at the last follow-up to evaluate the QOL. Results: Out of the 14 people, 8 reached 1-year follow-up. Time in Range (TIR) increased from 63% at baseline to 69% at 12 months, Time Below Range < 70 mg/dL (TBR70) decreased from 0.3% to 0%, and Time Above Range > 250 mg/dL (TAR250) decreased from 6.7% to 3.9%. Seven out of eight subjects who reached a 12-month follow-up achieved all three glycemic targets for this fragile population (TIR > 50%, TBR70 < 1% and TAR250 < 10%). At the last follow-up, 58.3% of the users were satisfied or very satisfied with their health status, versus only 25% with the previous treatment, and 81.7% had a good or very good QOL, whereas only 8.3% had a good QOL, and no one had a very good QOL with the previous treatment. Conclusion: This pilot real-world study showed how the use of an AID system is safe and can help to improve the glycemic outcomes and the QOL of people with diabetes in dialysis.