Beyond Insulin Alone: One-Year CGM Outcomes of Adjunctive Incretin-Based and SGLT2 Inhibitors Therapy in Type 1 Diabetes Using Open-Source Automated Insulin Delivery Systems

Introduction and Objective: Although automated insulin delivery systems are effective, their combination with adjunctive pharmacotherapy has not been well studied.This study evaluates whether adjunctive pharmacotherapy combined with open source automated insulin delivery systems improves glycemic outcomes over one year Methods: A retrospective cohort study was conducted at the BCDiabetes clinic in Vancouver, Canada, involving 357 participants with T1D who used open-source AID (OS-AID) systems. Participants received adjunctive incretin-based therapy with either semaglutide or tirzepatide alone (n=357), SGLT-2 inhibitor alone (n=68), or both treatments (n=59). Continuous Glucose Monitoring (CGM) metrics were analyzed at baseline and every three months over a 12-month period. Results: Average age was 47 years, duration of diabetes was 24 years and 65% were female. Average BMI was 29. Average Time in Range (TIR) rose from 63% at baseline to 73% at 12 months. Time below range averaged 2% and did not change. Trends in CGM over 12 months in Table 2. Conclusion: The combination of adjunctive pharmacotherapy with OS-AID systems results in sustained improvements in continuous glucose monitoring (CGM) metrics. Successful implementation requires personalized diabetes plans, including patient risk assessment and adjustments to pump settings with medication initiation or titration Disclosure: R. Alshareef: None. D. Clayton: None. T.G. Elliott: Advisory Panel; Current; Abbott Diabetes, Dexcom, Inc.