Características clínicas, controle glicêmico e qualidade de vida em pacientes usando sistemas de pâncreas artificial Android AAPS® no Brasil

Abstract

This study evaluated the safety and efficacy of the Android Artificial Pancreas System (AAPS) in Brazilian individuals with type 1 diabetes mellitus (T1D). A total of 371 participants were included, comprising 62 AAPS users and 309 non-users. The AAPS configurations used included a first-generation continuous glucose monitor (CGM), a Bluetooth transmitter (MiaoMiao), and a non-automated insulin pump. AAPS users achieved a mean Time in Range (TIR) of 78.5% ± 16.6, with a significant reduction in glycated hemoglobin (HbA1c) from 7.3% ± 1.03 to 6.5% ± 0.7 (p < 0.001). Compared with non-users, the AAPS group demonstrated better glycemic control, fewer severe hypoglycemic episodes (p = 0.006), and improved quality of life (p < 0.0001). Nevertheless, 23.08% of users had a TIR below 70%, and time spent in level-2 hypoglycemia exceeded current recommendations. These findings indicate that AAPS is a low-cost alternative to commercial automated systems, with the potential to expand access to automated insulin therapy, particularly in resource-limited settings. Despite relying on more affordable device configurations, AAPS users achieved glycemic parameters consistent with recommended targets for individuals with T1D. The observed improvements in HbA1c and quality of life reinforce the clinical feasibility and positive impact of AAPS use in Brazilian patients. However, the presence of suboptimal glycemic control among some users highlights the importance of appropriate medical follow-up and technical guidance during system setup and use. Therefore, AAPS emerges as a promising and accessible option for automated management of type 1 diabetes, contributing to the reduction of inequalities in access to health technology.