Successful transitioning children and adolescents with type 1 diabetes from multiple daily injections to advanced hybrid closed-loop system in 10 days: a prospective intervention study on MiniMed 780G system

Petrovski, Goran; Khalaf, Fawziya Al; Campbell, Judith; Day, Emma; Almajaly, Douha; Hussain, Khalid; Pasha, Maheen; Umer, Fareeda; Hamdan, Manar; Khalifa, Amal

doi:10.1007/s00592-022-01851-w

Cited by 10 publications

(12 citation statements)

References 5 publications

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“…Data obtained from 12 870 users of the MiniMed 780G system are consistent with previous real-world analyses, 1 smaller cohorts and clinical studies 4,15,16 and thus provide further evidence relating to the robust nature of the outcomes achieved with the 780G system. The robustness of the results across different countries and age groups (reported by Arrieta et al 17 ), combined with the sustained results beyond the initial interest in a new device, attest to the nature of the therapy, which is less dependent on users and their health care professionals (HCPs) and relies more on device automation.…”

Section: Discussionsupporting

confidence: 82%

“…more challenging users are put on more conservative settings, which in turn reflects back in the analysis. However, data published from individual clinic‐based cohorts using the optimized setting at the start or soon after initiation, report similar results: TIR 79.6 ± 7.9% and 3.2 ± 3.4% TBR 15 and 78.8 ± 6.1% TIR and 0.5 ± 0.4% TBR, respectively 16 . A study that did not adhere to the optimized setting reported achieving 3 h less TIR (67%) while TBR was only 16 min different (2.1%) 28 .…”

Section: Discussionmentioning

confidence: 64%

“…However, data published from individual clinic-based cohorts using the optimized setting at the start or soon after initiation, report similar results: TIR 79.6 ± 7.9% and 3.2 ± 3.4% TBR 15 and 78.8 ± 6.1% TIR and 0.5 ± 0.4% TBR, respectively. 16 A study that did not adhere to the optimized setting reported achieving 3 h less TIR (67%) while TBR was only 16 min different (2.1%). 28 We speculate that with further experience and following the data from real-world cohorts, more users will be using the optimized settings and bolus pre-meal.…”

Section: Discussionmentioning

confidence: 98%

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Predictors of time in target glucose range in real‐world users of the MiniMed 780G system

Castañeda

Mathieu

Aanstoot³

et al. 2022

Diabetes Obesity Metabolism

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Aim: Automated insulin delivery systems have improved glycaemic control in people with type 1 diabetes mellitus. The analysis investigated predictors of improved sensor glucose time-in-range (TIR; 70-180 mg/dl) based on real-world use of the MiniMed 780G advanced hybrid closed-loop (AHCL) system.Methods: Data uploaded by MiniMed 780G system users from August 2020-July 2021 were analysed using univariate and multivariable models to identify baseline, demographic and system use characteristics associated with TIR after AHCL initiation (post-AHCL). System settings associated with improved TIR post-AHCL were identified and their impact on time below range (TBR, <70 mg/dl) post-AHCL was explored.Results: In total, 12 870 users were included, of which 2977 had baseline sensor glucose data. Baseline TIR and time in AHCL (defined as the percentage of time the system was in Auto-mode) were positively associated with TIR post-AHCL with larger values predicting greater mean TIR post-AHCL. Characteristics inversely associated with TIR post-AHCL included the percentage of daily basal insulin dose, daily autocorrection dose, number of daily AHCL exits triggered by the system and number of daily alarms, wherein larger values of these characteristics predicted lower mean TIR post-AHCL. System settings that predicted the largest mean TIR post-AHCL were active insulin time of 2 h and glucose target of 100 mg/dl. Active insulin time was not associated with TBR post-AHCL. Conclusion:Modifiable factors, including optimized pump settings, can allow users to achieve glycaemic targets with >80% TIR. The findings from this analysis will potentially guide the optimal use of the MiniMed 780G system and facilitate meaningful improvements in safe glycaemic control.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 98%

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Predictors of time in target glucose range in real‐world users of the MiniMed 780G system

Castañeda

Mathieu

Aanstoot³

et al. 2022

Diabetes Obesity Metabolism

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“…We describe stable BMI z-scores of children and adolescents with T1D using the AHCL system during a 1-year follow up which is the first such long observation (34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45). Similar results, also for a pediatric cohort of individuals with T1D, were obtained by Tornese et al, who reported no change in BMI zscore after 6 months of insulin treatment using either the hybrid closed-loop (Minimed 670G) or AHCL (Minimed 780G) systems.…”

Section: Discussionmentioning

confidence: 99%

“…Noteworthy, our patients were characterized by more optimal glycemic control (lower GMI 6.48% vs 7.1% and higher TIR 81.16% vs 72%) after 6 months of AHCL use with a similar time spent in auto-mode (96.62% vs 96) and percent of sensor use (94.04% vs 92%) (36). Among the growing number of studies evaluating the AHCL Minimed 780G system these are to our knowledge the only two investigating the associations with BMI z-score (34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45). Former studies that observed BMI in children with T1D using insulin pumps other than AHCL showed not unequivocal results although the latest metaanalysis suggested no change in body mass (28, 29).…”

Section: Discussionmentioning

confidence: 99%

Body mass index, basal insulin and glycemic control in children with type 1 diabetes treated with the advanced hybrid closed loop system remain stable - 1-year prospective, observational, two-center study

et al. 2022

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BackgroundInformation on the influence of insulin treatment using advanced hybrid closed loop systems (AHCL) on body weight of young patients with type 1 diabetes (T1D) is scarce. The aim of this study was to observe whether there were any changes in body mass index (BMI) of children and adolescents with T1D treated using the Medtronic Minimed 780G AHCL after 1 year of follow up and to analyze potential associations between these changes and the insulin doses.Materials and methodsFor 50 children and adolescents (age 5.4-16.8 years, 24 (48%) boys, T1D for 3.9 ± 2.56 years) using an AHCL system anthropometric and AHCL data were collected prospectively. BMI Z-scores and two-week AHCL records obtained after AHCL enrollment were compared with data after 6 months and also 1 year after starting AHCL.ResultsThe BMI Z-score of the patients at 1 year follow-up did not change from time of AHCL initiation (0.51 ± 2.79 vs 0.57 ± 2.85, p>0.05). There was a slight increase in total daily insulin per kg of body weight (0.67 ± 0.21 U/kg vs 0.80 ± 0.21 U/kg, p <0.001), but the percent of basal insulin was unchanged (34.88 ± 6.91% vs 35.08 ± 6.30%, p>0.05). We observed also no change (AHCL start vs after 1 year) in glycemic control parameters: average sensor glucose (131.36± 11.04 mg/dL vs 132.45 ± 13.42 mg/dL, p>0.05), coefficient of variation (34.99± 5.17% vs 34.06 ± 5.38%, p>0.05), glucose management indicator (6.45 ± 0.26% vs 6.48 ± 0.32%, p>0.05), and time spent in the range of 70–180 mg/dL (79.28 ± 8.12% vs 80.40 ± 8.25%, p>0.05).ConclusionDuring the 1 year of follow-up the BMI of children and adolescents with T1D treated with an AHCL system remained stable. Although there was a slight increase in the total daily insulin dose, the percent of basal insulin was unchanged. The patients maintained recommended glycemic control.

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Insight into continuous glucose monitoring: from medical basics to commercialized devices

et al. 2023

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According to the latest statistics, more than 537 million people around the world struggle with diabetes and its adverse consequences. As well as acute risks of hypo-or hyper-glycemia, long-term vascular complications may occur, including coronary heart disease or stroke, as well as diabetic nephropathy leading to end-stage disease, neuropathy or retinopathy. Therefore, there is an urgent need to improve diabetes management to reduce the risk of complications but also to improve patient's quality life. The impact of continuous glucose monitoring (CGM) is well recognized, in this regard. The current review aims at introducing the basic principles of glucose sensing, including electrochemical and optical detection, summarizing CGM technology, its requirements, advantages and disadvantages. The role of CGM systems in the clinical diagnostics/personal testing, difficulties in their utilization and recommendations are also discussed. In the end, challenges and prospects in future CGM systems are discussed and non-invasive, wearable glucose biosensors are introduced. Though the scope of this review is CGMs and provides information about medical issues and analytical principles, consideration of broader use will be critical in future if the right systems are to be selected for effective diabetes management.

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Successful transitioning children and adolescents with type 1 diabetes from multiple daily injections to advanced hybrid closed-loop system in 10 days: a prospective intervention study on MiniMed 780G system

Cited by 10 publications

References 5 publications

Predictors of time in target glucose range in real‐world users of the MiniMed 780G system

Predictors of time in target glucose range in real‐world users of the MiniMed 780G system

Body mass index, basal insulin and glycemic control in children with type 1 diabetes treated with the advanced hybrid closed loop system remain stable - 1-year prospective, observational, two-center study

Insight into continuous glucose monitoring: from medical basics to commercialized devices

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