<scp>ISPAD</scp>
            Clinical Practice Consensus Guidelines 2022: Diabetes technologies: Insulin delivery

Sherr, Jennifer; Schoelwer, Melissa J.; Santos, Tiago Jeronimo Dos; Reddy, Leenatha; Biester, Torben; Galderisi, Alfonso; Dyk, J C van; Hilliard, Marisa E.; Berget, Cari; DiMeglio, Linda A.

doi:10.1111/pedi.13421

Cited by 85 publications

(39 citation statements)

References 353 publications

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“…AID systems have found their way into international guidelines on the treatment of type 1 diabetes (T1D), both in adults and in children. [1][2][3] The MiniMed (MM) 780G system, one of the most recent AID systems in the field, includes an advanced hybrid closed loop (AHCL) algorithm that automatically delivers basal insulin and autocorrection boluses every 5 min (as needed) aiming a predefined glucose target (GT). The MiniMed 780G system has been shown to achieve safely the internationally recommended glycaemic targets, both in clinical trials as in real-world analyses.…”

Section: Introductionmentioning

confidence: 99%

“…The rapid pace of innovation in automated insulin delivery (AID) systems has introduced unprecedented outcomes of glycaemic control in people with type 1 diabetes (PwT1D). AID systems have found their way into international guidelines on the treatment of type 1 diabetes (T1D), both in adults and in children 1‐3 . The MiniMed (MM) 780G system, one of the most recent AID systems in the field, includes an advanced hybrid closed loop (AHCL) algorithm that automatically delivers basal insulin and autocorrection boluses every 5 min (as needed) aiming a predefined glucose target (GT).…”

Section: Introductionmentioning

confidence: 99%

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Real‐world performance of the MiniMed 780G advanced hybrid closed loop system in Latin America: Substantial improvement in glycaemic control with each technology iteration of the MiniMed automated insulin delivery system

Grassi

Gómez

Calliari

et al. 2023

Diabetes Obesity Metabolism

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Aim We studied real‐world performance of MiniMed (MM) 780G system users from Argentina, Brazil, Colombia and Chile (geographical analysis), and the effect of each technology iteration of the MM system on glycaemic control (technology iteration analysis). Materials and Methods CareLink data from August 2020 to September 2022 were extracted. Endpoints included continuous glucose monitoring metrics. For the geographical analysis, aggregated endpoints for MM780G system users were calculated. For the technology iteration analysis, MM780G system user outcomes were compared with outcomes when the same individuals were still using the MM640G or MM670G system. Results On average, 1025 MM780G system users from the geographical analysis were followed for 136 (SD 135) days, spent 91.5 (14.3)% in advanced hybrid closed loop, showed a glucose management indicator (GMI) of 6.7 (0.3)%, a time in range between 70 and 180 mg/dl (TIR) of 76.5 (9.0)%, and a time below range 70 mg/dl (TBR) of 2.7 (2.1)%. The percentage of users reaching targets of GMI <7%, TIR >70% and TBR <4% was 80.8%, 78.1% and 80.1%, respectively. The technology iteration analysis on users transitioning from MM640G to MM780G system (N = 381) showed 0.4% decrease in GMI (7.1% to 6.7%, p < .0001), 10.7% increase in TIR (65.9% to 76.6%, p < .0001), while TBR remained. The percentage of insulin delivered automatically increased as well (47.5%‐57.7%, p < .0001). Users transitioning from MM670G system (N = 78) showed a similar but less pronounced pattern. Conclusions Real‐world Latin American MM780G users on average showed good glucose control, achieving international targets. Glycaemic control increased with every technology iteration of the MM system, providing more automation each time.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Real‐world performance of the MiniMed 780G advanced hybrid closed loop system in Latin America: Substantial improvement in glycaemic control with each technology iteration of the MiniMed automated insulin delivery system

Grassi

Gómez

Calliari

et al. 2023

Diabetes Obesity Metabolism

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show abstract

“…An additional limitation is that 36% of children reported to be on a low carbohydrate diet were on multiple daily injections compared to alternative pump or hybrid closed loop therapy, which afford tighter glucose control and may skew parental perceptions of impact of diet on blood glucose management compared to insulin technology [ 25 ]. With only thirteen families ( n = 14) completing the interviews, despite efforts to recruit more, the research team, believed the dataset collected was rich as it was composed of specific experiences and knowledge, which was sufficient in addressing the narrow research aim with strong communication between researcher and participant [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Experiences and Attitudes of Parents Reducing Carbohydrate Intake in the Management of Their Child’s Type 1 Diabetes: A Qualitative Study

et al. 2023

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Reducing carbohydrate (CHO) intake is being used as an approach to manage type 1 diabetes (T1D) in children. This study aimed to investigate the experiences and attitudes of parents of children with T1D who are reducing CHO intake to help manage blood glucose levels (BGLs). Semi-structured interviews were conducted with the parents of children with T1D for >1 year who reported implementing a low CHO approach to manage BGLs. Data were analysed using a constant comparative analysis approach. Participants (n = 14) were parents of children (6.6 ± 2.0 years) with T1D in Western Australia. All parents reported different methods of CHO restriction and all perceived that benefits outweighed challenges. Parents reported feeling less worried, had improved sleep and felt their child was safer when using a low CHO approach due to more stable BGLs. Reported challenges included: increased cost and time spent preparing food; perceived judgement from others; and child dissatisfaction with restricted food choices. Parents reported accessing information and support through social media networks. Parents reported a desire for more research into this approach. Understanding the promoters and barriers for this dietary approach may inform strategies to better engage and support families with approaches that align with current evidence while considering their concerns around safety and hyperglycaemia.

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“…Insulin pumps and CGM are commonly used to manage diabetes in pediatric patients. The most recent ISPAD guidelines advocate for the use of insulin pump therapy and CGM for all children with T1D 12,13 . As of 2018, over 60% of patients with T1D in the US used an insulin pump for management and 30% used CGMS 2 .…”

Section: Error 2: Failure To Understand Diabetes Technologymentioning

confidence: 99%

“…In addition, some systems can give insulin boluses to more aggressively treat hyperglycemia. Pumps may also have separate modes for exercise or sleep that adjust algorithms to compensate for changes in physical activity 12 . These systems can also be changed to a manual mode, which delivers basal insulin at a fixed rate independent of CGM data.…”

Section: Error 2: Failure To Understand Diabetes Technologymentioning

confidence: 99%

Error traps in the perioperative management of children with type 1 diabetes

Hoagland,

Duggar,

Hamrick

et al. 2023

Pediatric Anesthesia

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Patients with type 1 diabetes mellitus (T1D) require insulin administration at all times to maintain euglycemia and metabolic stability. Insulin administration in the perioperative period is complicated by fasting requirements and perioperative stressors that can change the patient's insulin needs. In addition, many anesthesia providers are not familiar with insulin dosing strategies and technology, such as insulin pumps and continuous glucose monitors (CGMs), that are commonly used by patients with T1D. Errors in perioperative insulin administration can lead to hypoglycemia, hyperglycemia, and diabetic ketoacidosis. This article reviews common errors of associated with the perioperative management of patients with T1D, including failure to assess and coordinate patient care preoperatively; failure to understand diabetes management and technology; failure to monitor blood glucose and recognize dysglycemia; and failure to appropriately administer basal insulin.

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ISPAD Clinical Practice Consensus Guidelines 2022: Diabetes technologies: Insulin delivery

Cited by 85 publications

References 353 publications

Real‐world performance of the MiniMed 780G advanced hybrid closed loop system in Latin America: Substantial improvement in glycaemic control with each technology iteration of the MiniMed automated insulin delivery system

Real‐world performance of the MiniMed 780G advanced hybrid closed loop system in Latin America: Substantial improvement in glycaemic control with each technology iteration of the MiniMed automated insulin delivery system

Experiences and Attitudes of Parents Reducing Carbohydrate Intake in the Management of Their Child’s Type 1 Diabetes: A Qualitative Study

Error traps in the perioperative management of children with type 1 diabetes

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