Jirawan Pongrujikorn, Jutipond Jitchana, Nitchakarn Laichuthai
This study found a relatively high rate of diabetes technology adoption at our center compared to other Asian countries, highlighting its potential to reduce the risk of hypoglycemia and improve glycemic stability. However, technology users also had higher HbA1c levels, suggesting that diabetes technology is often prescribed to high-risk patients with poor glycemic control. Future research should focus on longitudinal studies to better understand and address barriers to optimal glycemic outcomes among diabetes technology users.
BACKGROUND: While diabetes technologies such as insulin pumps, continuous glucose monitoring (CGM), and automated insulin delivery (AID) systems have demonstrated potential to improve glycemic control and reduce hypoglycemia, their utilization and effectiveness in Thailand remain underdocumented. This study aimed to assess the use and impact of diabetes technologies on glycemic outcomes at King Chulalongkorn Memorial Hospital (KCMH), a tertiary care center in Bangkok, Thailand.
METHODOLOGY: A cross-sectional study was conducted among T1D patients receiving care at the endocrinology clinic of KCMH between August 2023 and July 2024. Data were collected at each patient's most recent follow-up visit, and participants were classified into technology users and non-technology users. Data collection focused on demographics, diabetes technology use, and clinical parameters, including HbA1c, hypoglycemia events, and CGM metrics (Time in Range (TIR), Time Above Range (TAR), Time Below Range (TBR)).
RESULTS: A total of 61 patients with T1D were included, of whom 49% were technology users (6% insulin pumps, 57% CGM, 37% AID). Technology users had a significantly higher mean HbA1c (8.1% ± 1.6) than non-technology users (7.2% ± 1.2, p = 0.011). AID users achieved a higher mean TIR (67.6% ± 16%) compared to CGM users (54.0% ± 23.8%), but the difference was not statistically significant. Both AID and CGM users maintained a low incidence of hypoglycemia (<54 mg/dL).
CONCLUSION: This study found a relatively high rate of diabetes technology adoption at our center compared to other Asian countries, highlighting its potential to reduce the risk of hypoglycemia and improve glycemic stability. However, technology users also had higher HbA1c levels, suggesting that diabetes technology is often prescribed to high-risk patients with poor glycemic control. Future research should focus on longitudinal studies to better understand and address barriers to optimal glycemic outcomes among diabetes technology users.