Available online 11 July 2022, 108262

High Time in Range with low risk of hypoglycemia can be achieved with a simple insulin pump configuration.

The number of segments of basal, ratio, sensitivity on a PLGS augmented pumps have no correlation with time in range.

More than 180 min per day of insulin suspension correlates with excessive time bellow range.

A value for PLGS operation of 50 mg/dL could be associated with significantly more time in hypoglycemia.

Sensor augmented insulin pumps have become a powerful tool for managing type 1 diabetes (T1D). This study aimed to analyze the insulin pump configuration in users of predictive insulin suspension technology (PLGS).

T1D patients on insulin pumps with PLGS (Medtronic 640G®) were enrolled. Data was obtained from medical records and pump data was downloaded for 30 days. Basal insulin, bolus calculator parameters, and PLGS operation parameters were analyzed and compared with Time in Range, Time Below Range, and Time Above Range.

112 patients were included, with average TIR of 73,96 % and HbA1c 7,0 % and 25 months of follow-up. Basal insulin remained similar to initial doses, with an increase of 27 % for the Dawn phenomenon. The Carbohydrate ratio was slightly more aggressive. Insulin sensitivity was 17 % less stringent than initially programmed. No differences were observed in Time in Rage according to the number of basal, ratio, and sensitivity segments. Time of insulin suspension correlated directly with Time Bellow Range.

Patients with good metabolic control have basal insulin programming similar to their initiation doses with less aggressive sensitivity factors. Excessive suspension time determined by PLGS could be an expression of excess insulin and increased hypoglycemia risk.

Type 1 diabetes

Insulin pumps

Predictive low glucose suspend

Continuous glucose monitoring

Diabetes education

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