What Happens When People Don’t Bolus for Extended Periods of Time While Using Control-IQ Technology?

Individuals with diabetes often face challenges in managing diabetes-related tasks such as glucose monitoring, insulin treatment, and maintaining glycaemic control, leading to a psychosocial burden. Integrating new devices and technologies into diabetes care is crucial to improve quality of life. During the American Diabetes Association (ADA) Scientific Sessions in Orlando, Florida, USA, on 21st–24th June 2024, Miranda R. Polin, Senior Data Analyst at Tandem Diabetes Care in San Diego, California, USA, presented a poster entitled ‘What Happens When People Don’t Bolus for Extended Periods of Time while Using the t:slim X2 with Control-IQ Technology?’ summarising glycaemic data in relation to bolus administration. The study utilised real-world data from users of an automated insulin delivery (AID) system that incorporates continuous glucose monitoring (CGM) and an insulin pump with advanced hybrid closed-loop technology (t:slim X2TM with Control-IQ Technology, Tandem Diabetes Care, San Diego, California, USA) to automate insulin delivery. Polin provided insight regarding the glycaemic control seen in users of Control-IQ Technology who do not manually bolus for prolonged periods of time. The study demonstrated a higher time-in-range (TIR; 3.9–10.0 mmol/L [70–180 mg/dL]) on the days they did not bolus, compared with manual bolusing, without increasing the risk of hypoglycaemia. Polin suggested that when using systems such as Control-IQ Technology, even without user given boluses, adequate glycaemic control may be achieved under certain conditions. This opens up the possibility that closed-loop technology can positively impact outcomes even when user behaviours are not consistent.