Objective: Fear of hypoglycemia interferes frequently with metabolic control of type 1 diabetes especially in patients under 5 years of age who are at high risk of hypoglycemia and low metabolic control. Medtronic Minimed 640 G insulin pump with Smart Guard technology (suspension of insulin perfusion in predictive hypoglycemia situations) appears to be an adequate system for these patients by reducing the risk of hypoglycemia.
Research design and methods: Retrospective study, patients with type 1 diabetes using Medtronic Minimed 640 G with Smart Guard technology. Carelink-Pro software used to follow continuous glucose monitoring (CGM) as well as HbA1c.
Results: 11 patients with type 1 diabetes, median age 4.5 years old (22 months 8 years old), 27% girls, 73% boys. Median age at diagnosis 22 months old (1140 months old). Insulin pump (Medtronic Minimed 640 G) used on average 12.5 months after diagnosis. CGM + Smart Guard technology added on average 7.1 months after starting insulin pump. Study duration: 624 months. Significant reduction of time spent in hypoglycemia: 690 episodes of hypoglycemia per month before intervention, 010 minutes of hypoglycemia during the last month of the study and an average duration of 145 minutes of stopped insulin administration (113204 minutes). No major hypoglycemia noted neither hyperglycemia or Ketosis secondary to transient treatment suspension. Significant improvement of metabolic control, average HbA1c 8,26% before intervention and, 7.7% at the end of the follow-up: 0.56% of average reduction (P=0.03).
Conclusion: The Medtronic Minimed 640 G with the option of transient insulin administration suspension before hypoglycemia shows a positive impact in the treatment of type 1 diabetes allowing physicians to attempt metabolic control, with limited episodes of hypoglycemia and better quality of life of patients and their families.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology