Adults with Type 2 Diabetes Benefit from Automated Insulin Delivery Irrespective of C-peptide Level

<p dir="ltr">Objective: The Center for Medicare and Medicaid Services (CMS) requires a low C-peptide level for insulin pump coverage unless the individual is beta cell autoantibody positive, which precludes coverage of automated insulin delivery (AID) systems for many people with type 2 diabetes.</p><p dir="ltr">Research Design and Methods: In the 2IQP randomized trial evaluating the t:slim X2 insulin pump with Control-IQ+ technology, adults with insulin-treated type 2 diabetes were categorized into ‘high C peptide’ (N=195) and ‘low C-peptide’ (N=59) groups based on CMS criteria. </p><p dir="ltr">Results: In the AID group, mean HbA1c decreased from baseline by 0.8% which was significantly greater than the control group with both high (P<0.001) and low C-peptide (P=0.02). Results were similar in participants ≥65 years old.</p><p dir="ltr">Conclusions: The benefit of AID is present with high and low C-peptide levels. Thus, requiring a low C-peptide level as a prerequisite for AID therapy is not warranted.</p><p><br></p>