813-P: Successful Use of Hybrid Closed Loop Insulin Pumps with GLP1 Agonists in Diabulimia and Disordered Eating in Type 1 Diabetes

Introduction:We present two cases of T1D with binge eating disorder(BED) benefitted by GLP-1 agonists with Hybrid closed loop(HCL) insulin pump(CSII). Case 1:35-year-old female with T1D, obesity had high diabetes distress score(DDS), fear of hypoglycaemia, and emotional eating. She was on non-HCL CSII (Tandem Diabetes Care t:slim X2™ Insulin Pump), later Dexcom G6® Continuous Glucose Monitoring(CGM) with Control-IQ™ Technology and insulin Lispro for binge eating hyperglycaemia. She was supported by motivational interviewing, commenced Dulaglutide injections. Her food cravings reduced, felt positive about diabetes self-management and insulin requirement reduced by 25%. Case 2:42-year-old female with T1DM, obesity, poor compliance, multiple diabetic ketoacidosis (DKA), nephropathy, retinopathy, diabulimia, high DDS; was commenced on Dulaglutide injections with HCL CSII (MiniMed™ 780G system with SmartGuard™ technology and Guardian™ 4 CGM). Renal function, quality of life score improved; insulin requirement reduced by 32% Discussion:GLP-1 agonists with HCL CSII improved patient satisfaction scores, metabolic profile, weight, HbA1c, insulin requirement, blood pressure with no increase in DKA or hypoglycaemia. GLP-1 agonists are beneficial in binge eating without diabetes. Larger studies for complex T1D, diabetes distress, diabulimia may be warranted. Disclosure N. Basavaraju: None. A. Jones: None. P. Moulik: None.