- Journal
- JOURNAL OF DIABETES SCIENCE AND TECHNOLOGY
- Année
- 2025
- Mois
- 2025 OCT 5
- DOI
- 10.1177/19322968251380291
Abstract
Background: Hybrid closed-loop (HCL) therapy helps reaching efficacy and safety glucose targets (ESGT+) in persons with type 1 diabetes (PwT1D). We analyzed here the glycemia risk index (GRI) in PwT1D at HCL initiation (M-0) and at 12 months (M-12) and determined whether M(0)GRI value and/or M(0)GRI zone (A-B-C-D-E) could identify people reaching M(12)ESGT+. Methods: This was a retrospective study. Consecutive PwT1D who started HCL in a CIRDIA center were included after written consent. Glucose parameters were manually extracted from platforms at M-0 and M-12. ESGT+ meant reaching time in range (TIR) > 70% and glucose management indicator < 7% and time below range (TBR)(<70) < 4% and TBR<54< 1%. Glycemia risk index was calculated and receiver-operating characteristic (ROC) analyses were performed to study the relation between M(0)GRI and M(12)ESGT+/M(12)ESGT-. Results: M-12 data were available for 128 PwT1D. M(0)GRI predicted M(12)ESGT mostly for low and high M(0)GRI values. An M(0)GRI < 41 had a 90% specificity, a 36% sensitivity, and a 74% positive predictive value for M(12)ESGT+. Sensitivity increased to 80% but specificity dropped to 56% for M(0)GRI < 61 and M(0)GRI >= 61 had a 78% negative predictive value. All PwT1D with M(0)GRI 0 to 20 (zone A) reached M(12)ESGT+. Then, the percentage of M(12)ESGT+ people dropped about 25% per M(0)GRI zone (A-B-C-D) and to 11% for zone E. Conclusions: M(0)GRI was significantly associated with M(12)ESGT status but mostly when in zones A-B or D-E. Hybrid closed-loop training should focus on PwT1D with M(0)GRI >= 41 (90% of M(12)ESGT- persons), but reaching M(12)ESGT+ is possible with M(0)GRI in zones C-D-E (64% of M(12)ESGT+ persons) and even D-E (20% of M(12)ESGT+ persons).