Additive Benefits of Control-IQ+ AID to GLP-1 Receptor Agonist Use in Adults with Type 2 Diabetes

<p dir="ltr">Objective: To assess the effect of automated insulin delivery (AID) on glycemic and insulin outcomes in adults with insulin-treated type 2 diabetes using a glucagon-like peptide-1 receptor agonist (GLP-1ra).</p><p dir="ltr">Research Design and Methods: In a randomized trial comparing Control-IQ+ AID versus continuation of pre-study insulin delivery method plus continuous glucose monitoring (CGM group), 143 (45%) of the 319 participants were using a GLP-1ra at baseline, which was continued during the trial. </p><p dir="ltr">Results: Among GLP1-ra users, mean HbA1c decreased by 0.8% from a baseline of 8.0±1.2% with AID, which represented a mean improvement of -0.5% (95% CI -0.8 to -0.3, p<0.001) compared with the CGM group. Time-in-range 70-180 mg/dL and other CGM metrics reflective of hyperglycemia also showed comparable statistically-significant improvements using AID when added to GLP-1ra use. For GLP-1ra users, there was no significant difference in weight after 13 weeks with AID compared with the CGM group (0.9 kg, 95% CI -0.2, 2.1, p=0.10), whereas in GLP-1ra nonusers there was a mean weight gain of 1.9 kg with AID compared with CGM (95% CI 0.5, 3.2, p=0.007). </p><p dir="ltr">Conclusion: The benefits of AID appear to be substantial for a broad spectrum of insulin-treated patients with type 2 diabetes, including those already receiving contemporary and guideline-directed therapy, such as a GLP-1ra medication. These additive benefits of AID in GLP-1ra users included significant reductions in HbA1c levels with simultaneous reduction in insulin use, along with no statistical increase in weight despite very significant improvements in glycemic control. </p>