Improvements in both glycaemic and inflammatory profile in people with type 1 diabetes using automated insulin delivery systems

Abstract

Aims: Automated insulin delivery (AID) systems have been developed to achieve optimal glycaemic targets to prevent or slow the progression of type 1 diabetes (T1DM) and its complications. The aim of this study is to analyse the glycemic and inflammatory profile in people with T1DM after one year of using an AID system.

Materials and methods: A longitudinal study was performed, including 33 patients who started their treatment with an AID system (Medtronic 780G - 19%, Tandem Control-IQ - 27% and Roche-Diabeloop - 54%). A biochemical analysis was performed, and a blood sample was collected prior to pump implantation and at 3, 6, and 12 months.

Results: A significant increase in time in range was observed from the first month, with significant differences always relative to baseline (p<0.001). The coefficient of variation was significantly reduced from implantation and this reduction was maintained up to one year (p=0.002). Similarly, significant reductions in HbA1c (p<0.001) and blood glucose levels (p=0.001) were observed. The expression of IL6, IL1β, TNFα and VEGF was analysed in the peripheral mononuclear cells of the same cohort, observing a significant decrease in IL1β (p=0.047), as well as a trend of decrease in the gene expression levels of the other molecules. In addition, correlations between these genes and certain biochemical parameters were observed.

Conclusions: After one year of AID system use, we observed a significant reduction in IL1β expression, independent of baseline glycaemic control. This reduction correlated with total cholesterol, HDL, and LDL levels. Moreover, individuals with poorer initial glycaemic control showed a greater decrease in IL6 levels. These findings suggest that AID use may contribute to modulating specific inflammatory markers in people with T1DM, with differential effects depending on initial metabolic status.

Keywords: AID; Artificial intelligence; Diabetes mellitus tipo 1; Inflamación; Inflammation; Inteligencia artificial; Sistemas de asa cerrada híbridos; TIR; Tiempo en rango; Type 1 diabetes.