Effect of Active Insulin Time and Glycemic Targets on Automatic Correction Bolus Delivery.
TL;DR
Active insulin time is a key modifiable parameter influencing AB delivery and glycemic outcomes, and shorter AIT settings were associated with increased AB administration and improved TIR, whereas glucose target settings had no significant impact on these outcomes.
Abstract
Background
This study examined how automatic correction boluses (ABs) vary according to active insulin time (AIT) and glucose target settings, and how these parameters impact glycemic control in individuals with type 1 diabetes.
Methods
Retrospective data from 287 individuals with type 1 diabetes using the MiniMed 780G system in auto-mode for at least 80% of the time over a minimum period of 6 months were analyzed. The AB delivery was evaluated in relation to different AIT and glucose target settings. Glycemic outcomes, including time in range (TIR 70-180 mg/dL), were assessed.
Results
Automatic correction boluses accounted for 33.1% of bolus insulin and 18.3% of the total daily insulin dose (TDD). Active insulin time settings significantly influenced AB delivery: individuals using a 2-hour AIT showed higher percentages of ABs relative to both TDD and bolus insulin, as well as higher AB doses expressed in IU/kg/day. Shorter AIT settings were also associated with improved TIR. In contrast, glucose target settings ranging from 100 to 120 mg/dL did not significantly affect AB delivery or TIR.
Conclusion
Active insulin time is a key modifiable parameter influencing AB delivery and glycemic outcomes. Shorter AIT settings were associated with increased AB administration and improved TIR, whereas glucose target settings had no significant impact on these outcomes.