LAUSR

Abstract Introduction The advancement in technology now allows insulin pumps and Continuous Glucose Sensor (CGM) as part of usual clinical care. Insulin pump therapy integrated with CGM technology is also known as Automated Insulin Pump (AIP) or “artificial pancreas”. In the automated insulin pump mode, the device delivers insulin automatically based on CGM readings. This closed loop system has shown to improve glycemic control while preventing hypoglycemic events. We aimed to assess the AIP technology in a specialized Insulin Pump Clinic at the VA Medical Center. Hypothesis Use of an automated insulin pump in patients with diabetes improves glycemic control. Methods Retrospective evaluation of patients seen in the Diabetes Clinic at the Malcom Randall VA Medical Center, between March 2018 and September 2018, when the AIP system (Medtronic 670g) became available at the VA was performed. We collected clinical data before and after the initiation of AIP including A1C and insulin pump/CGM information: average sensor glucose, percentage of time in target ranges, sensor wear and time in automated mode. Results We assessed 32 patients new to AIP. The most common diagnosis was type 1 diabetes (n=25), and type 2 diabetes (n=5). The average age at the time of the initiation of the AIP was 63.25 (SD=11.45), Most of patients were male (n=30). On average, patients had diabetes for 26.19 (SD=11.49) years prior to initiation of AIP. The A1c before AIP was 7.64% (SD=1.19). The A1c after initiation of AIP was 7.45% (SD=0.90). In the interim analysis of half of the patients, a second A1c, was reported at 7.18% (SD 0.75). Conclusion Automated insulin pump leads to improved glycemic control in patients with diabetes. This technology further engaged patients in monitoring their blood sugars and achieving more optimal glycemic control.