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Real-world outcomes of the DBLG1 hybrid closed-loop system in adults living with type 1 diabetes in Belgium

par Lytrivi, Maria ;Thielen, Vincianne;Vercammen, Chris;Matthys, Imke;De Block, Christophe;Gillard, Pieter;Radermecker, Regis;Ramon, Isolde;Van Huffel, Liesbeth;Scarniere, Denis;Colin, Ides M;Preumont, Vanessa;Crenier, Laurent
Référence 61st EASD Annual Meeting of the European Association for the Study of Diabetes(Vienna, Austria, 15 - 19 September 2025: Vienna), 61st EASD Annual Meeting of the European Association for the Study of Diabetes, Diabetologia (Diabetologia (2025) 68 (Suppl 1):S1–S754), doi: 10.1007/s00125-025-06497-1
Publication Publié, 2025-09-20

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Real-world outcomes of the DBLG1 hybrid closed-loop system in adults living with type 1 diabetes in BelgiumM. Lytrivi1, V. Thielen2, C. Vercammen3, I. Matthys4, C. De Block5, P. Gillard6, R. Radermecker7, I. Ramon8, L. Van Huffel9, D. Scarnière10, I. Colin11, V. Preumont12, L. Crenier1;1HUB-Hôpital Erasme, ULB, Brussels, Belgium, 2Citadelle Hospital, Liège, Belgium, 3Imeldaziekenhuis, Putte, Belgium, 4UZ Gent, Ghent, Belgium, 5Antwerp University Hospital, Antwerp, Belgium, 6UZ Leuven, Leuven, Belgium, 7CHU Liège, Liège, Belgium, 8Char- leroi University Hospital, Charleroi, Belgium, 9AZORG, Aalst, Belgium, 10Grand Hôpital de Charleroi, Charleroi, Belgium, 11CHU Helora, Mons, Belgium, 12UCLouvain, Brussels, Belgium.Background and aims: This study aimed to assess glycemic and patient-reported outcomes in adults with type 1 diabetes before and after initiation of the DBLG1 hybrid closed-loop system, integrated with the Accu-Chek Insight insulin pump and Dexcom G6 continuous glucose monitoring (CGM) sensor.Materials and methods: In this prospective cohort study, adults with type 1 diabetes who started using the DBLG1 system between May 2022 and September 2023 were enrolled across 12 specialized diabetes centers in Belgium. Clinical and CGM data were collected at baseline, 4, 8, and 12 months. The primary endpoint was the change in time in range (TIR; glucose 3.9-10.0 mmol/L) from start to 12 months. Baseline characteristics are presented as means ± SD, and outcomes as least squares means (95% CI).Results: 167 patients were included, with a mean age of 44 ± 12 years, of whom 62% were female. The mean diabetes duration was 19 ± 13 years; 78% were prior insulin pump users and 95% prior CGM users. TIR increased from 57 (53, 60) % at baseline to 69 (66, 72) % at 12 months (p < 0.001). The proportion of patients achieving the consensus TIR target of more than 70% rose from 18% to 47% (p < 0.001). HbA1c decreased from 59.7 (57.5, 61.9) mmol/mol [7.6 (7.4, 7.8)%] to 53.0 (50.8, 55.2) mmol/mol [7.0 (6.8, 7.2)%] (p < 0.001), and time spent in hypoglycemia (<3.9 mmol/L) decreased from 3.7 (3.2, 4.2)% to 1.4 (1.1, 1.6)% (p < 0.001). Patient-reported outcomes showed significant improvement over the study period. Scores on the Hypoglycemia Fear Survey-II decreased from 24.9 (22.3, 27.5) to 19.4 (16.6, 22.2) for the worry subscale, and from 19.5 (18.4, 20.7) to 17.6 (16.3, 18.8) for the behavior subscale (both p < 0.001). The Problem Areas in Diabetes- Short Form score improved from 8.0 (6.5, 9.5) to 6.9 (5.3, 8.4) (p = 0.001), and treatment satisfaction, as measured by the Diabetes Treat- ment Satisfaction Questionnaire, increased from 32.3 (31.1, 33.5) to 35.9 (34.5, 37.2) (p < 0.001, moderate effect sizes, Cohen’s d). The incidence of self-reported severe hypoglycemic events decreased mark- edly, from 28.5 (10.6, 76.1) to 1.7 (0.3, 9.7) events per 100 person- years (p = 0.004). The cumulative dropout rate was 9.6% at 12 months, with technology-related burden cited as the most common reason. Conclusion: This real-world study, including 93% of DBLG1 users in Belgium, indicates that use of the DBLG1 system over 12 months is associated with improved glycemic control, reduced hypoglyce- mia, enhanced diabetes-related quality of life, and increased treat- ment satisfaction.