Glucose metrics and device satisfaction in adults with type 1 diabetes using different treatment modalities: a multicenter, real-world observational study

Aims: To evaluate glucose metrics, device satisfaction and diabetes impact in adults with type 1 diabetes using different treatment modalities in a real-life setting in Italy. Methods: This was a multicentre, nationwide, cross-sectional study. Candidates were consecutively evaluated for eligibility during their routine medical visit at the diabetes centre. Researchers collected comprehensive demographic, socioeconomic, anamnestic and clinical data, and administered the Diabetes Impact and Device Satisfaction scale. Results: From 2021 to 2022, a total of 428 subjects, 45% males, with a median age of 32 years (IQR 23-47) were recruited in 11 participating centres from all over Italy. No differences in age, physical activity, and diabetes impact were found for the different treatment modalities. HCL/AHCL and SAP groups reported higher device satisfaction vs. MDI + SMBG and MDI + CGM (p < 0.001). Subjects treated with HCL/AHCL exhibited significantly higher TIR and significantly lower time spent in hypoglycemia level 1, time spent in hyperglycemia, CV and GMI compared to MDI + CGM, and significantly higher TIR and significantly lower time spent in hypoglycemia level 2, time spent in hyperglycemia, and CV compared to SAP. Significant reduction in hypoglycemia level 2 was also found with PLGM compared to SAP. High education attainment was associated with optimal metabolic control. Conclusion: Real-life use of advanced technologies for type 1 diabetes is associated with improved glucose metrics and device satisfaction. Education level also contributes to success of treatment.