What Thailand's Real-World Data Shows About Diabetes Technology and Blood Sugar Control

Researchers at King Chulalongkorn Memorial Hospital in Bangkok wanted to understand how diabetes technology is being used in their clinic and whether it improves blood sugar outcomes. Between August 2023 and July 2024, they collected information from 61 people with Type 1 diabetes during routine visits. They compared those using technology with those managing diabetes without it, looking at blood sugar control, low blood sugar events, and how much time patients spent in their target glucose range.

About half the patients in the study—49%—were using some form of diabetes technology. Among those users, the breakdown was: 57% were using continuous glucose monitors (CGMs), 37% were using automated insulin delivery systems (AID), and 6% were using insulin pumps alone. This relatively high adoption rate suggests that access to and interest in these tools is growing at this hospital center.

When researchers compared average HbA1c levels (a measure of long-term blood sugar control), they found an important detail: technology users had a higher average HbA1c of 8.1% compared to 7.2% in non-users. This might seem counterintuitive, but it likely reflects a real-world pattern: people whose diabetes is harder to manage are often the ones who choose to adopt technology in hopes of improving control.

When looking at time in range—the percentage of time patients spend with their blood sugar in a healthy target zone—AID users did better than CGM-only users. AID users spent about 68% of their time in range, while CGM users spent about 54%. However, this difference wasn't statistically significant in this study, meaning the difference could be due to chance.

Good news on low blood sugar: both AID and CGM users kept their dangerous low blood sugar events (below 54 mg/dL) to a low rate.

This study offers a real-world snapshot of how diabetes technology performs outside of controlled research settings. It suggests that when people with Type 1 diabetes have access to these tools, they use them—and they tend to use them most when their diabetes is more challenging to control. While AID systems showed promise in helping patients spend more time in their target range, both AID and CGM technology appear effective at reducing dangerous low blood sugar events, which is an important safety benefit.

These findings come from one hospital in Thailand, so results may differ in other settings and populations. More research comparing these technologies in different communities and healthcare systems can help clinicians and patients make informed decisions about which tools might work best for individual needs.

Source: Journal of the ASEAN Federation of Endocrine Societies. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.