Effect of Real-life insulin pump with predictive low-glucose management use for 3 months: Analysis of the patients treated in a Japanese center.

AIMS/INTRODUCTION: In Japan, an insulin pump with predictive low-glucose management (PLGM) was launched in 2018. It automatically suspends insulin delivery when the sensor detects or predicts low glucose values. The aim of this study was to analyze the safety and efficacy of PLGM in the patients treated in a Japanese center. MATERIALS AND METHODS: We conducted a retrospective observational analysis of 16 patients with type 1 diabetes mellitus and 1 patient after pancreatectomy. They switched from the MiniMed 620G device to the 640G device with PLGM. The primary outcome was the change in the percentage of time in hypoglycemia. The secondary outcome was the change in HbA1c (%) over 3 months. We also explored the presence of "post-suspend hyperglycemia" with the 640G device. RESULTS: After changing to the 640G device, the percentage of time in hypoglycemia (glucose 180 mg/dL) significantly increased from 25.53% (15.78-44.14%) to 32.9% (24.71-45.49%) (P=0.0373). HbA1c significantly increased from 7.6±1.0% to 7.8±1.1% (P=0.0161). From 1.5 to 4.5 hours after the resumption of insulin delivery, the percentage of time in hyperglycemia was 32.23% (24.2-53.75%), but it was significantly lower, 2.78% (0-21.6%), when patients manually restarted the pump within 30 minutes compared with automatic resumption 31.2% (20-61.66%) (P=0.0063). CONCLUSIONS: PLGM is an effective tool for reducing hypoglycemia but possibly elicits "post-suspend hyperglycemia." This information is useful for achieving better blood glucose control in the patients treated with PLGM.