949-P: Android Artificial Pancreas System Use among Patients with Type 1 Diabetes Mellitus in China—A Real-World Study

Objective: The real-world study aimed to investigate the current status of Android artificial pancreas system (APS) use among patients with type 1 diabetes mellitus (T1DM) in China, where market-approved commercial APS is unavailable. Methods: The healthcare providers of China’s largest online T1DM community (TTQ) helped build up AndroidAPS using a compatible insulin pump, real-time continuous glucose monitoring (CGM), and a heuristic-based algorithm. Patients with T1DM who used AndroidAPS for at least 3 months between January 2020 and July 2023 were included. The baseline data and main glycemic metrics during the last 3 months after using AndroidAPS were collected. Results: We included 191 patients (56 non-adults and 135 adults) with a median age of 24.80 (15.83, 32.74) yrs, T1DM duration of 6.01(1.63,8.58) yrs, and body mass index (BMI) of 20.74(18.51,22.34) kg/m2. The duration of APS use was 153(114.00,206.00) days. After using AndroidAPS, HbA1c was decreased from 7.1(6.4,8.5) % to 6.3(5.6,6.8) % (p<0.001). The median 24-hour time in range (TIR,70-180mg/dL), time above range (TAR,>180mg/dL), time below range (TBR, <70mg/dL), TBR(<54mg/dL), and glucose management indicator were 81.40(71.99,87.10) %, 13.55(7.20,22.37) %, 4.06(2.63,6.28) %, 0.42(0.20,0.87) %, and 6.45(6.09,6.78) %, respectively. The median overnight TIR, TAR, TBR (<70mg/dL), and TBR(<54mg/dL) were 85.42(77.87,91.87) %, 8.00(3.45,16.52) %, 3.82(2.00,6.44) %, and 0.39(0.11,0.95) %, respectively. A total of 155 patients achieved the recommended TIR of 70%, and 66 achieved TIR, TAR, and TBR targets simultaneously. Multiple linear regression revealed age (β=0.285, p<0.01) and duration of APS use (β=-0.167, p<0.05) as determinants of 24-hour TIR after adjusting gender, duration, BMI, and baseline HbA1c (R2=0.13, p<0.01). Conclusion: Our study confirmed the efficacy and safety of AndroidAPS on glycemic control among Chinese patients with T1DM, especially at nighttime. Disclosure M. Lei: None. P. Ling: None. Y. Ni: None. X. Zeng: None. D. Yang: None. H. Deng: None. X. Yang: None. W. Xu: None. J. Yan: None. Funding the Science and Technology Planning Project of Guangzhou (202102010154) and the Diabetes Mellitus Research Fund Program from Shanghai Medical and Health Development Foundation (DMRFP_II_14 from SHMHDF)