ESPE Abstracts (2021) 94 P1-22

ESPE2021 ePoster Category 1 Diabetes A (10 abstracts)

Early meal reporting enhances post-prandial glycaemic balance but remains underused in teenagers with artificial pancreas

Emma Villeneuve 1 , Sylvain Lachal 2 , Guillaume Charpentier 3 , Sylvia Franc 4,3 & Yousra Tourki 2

1Université Grenoble Alpes, CEA, LETI, Grenoble, France; 2Diabeloop SA, Grenoble, France; 3CERITD, Evry, France; 4Centre Hospitalier Sud Francilien, Corbeil Essones, France

Background and aims: In an artificial pancreas, the meal management depends on the meal size and time being reported to the system. Because of the delay of insulin action, it is recommended to declare a meal in advance to allow insulin to limit the glycaemic peak. We aim to assess if the post-prandial glycaemic balance improves as meals are reported in advance.

Clinical dataset: As part of Diabeloop DBLUS clinical trial (NCT04190277), 37 teenagers (age [14-18]) with type 1 diabetes were equipped with an artificial pancreas close-loop (CL) during 12 weeks in real life conditions. Data include CGM and meal reports. We select patients with more than 80% of CL in total, and data of days with more than 70% CL.

Frequency: First, the frequency and time intervals of early meal reporting (EMR) events are computed for every patient. We consider a meal to be reported early if the reporting is done at least 5 min before the meal.

Based on the 822 selected meals, the 26 teenagers tend to rarely report their meal in advance, with a median frequency of 3.2% (min = 0%, max=20.4%). The time interval between EMR and meal times is short, with a median of 10 min (min = 5 min, max= 35min).

Impact: Then, we compare the glycaemic post-prandial balance after an EMR or a standard meal reporting (SMR), during a window of 1 hour after meals. We select the eight patients with at least two EMR and two SMR, leaving a dataset of 47 EMR and 214 SMR. The meal size remains overall similar, with a median null variation over the individual median meal sizes (min = -10g, max = +13g). The median percentage of time in normal range ([70-140] mg/dL) of each patient globally increases with EMR, with a median increase of 8% (min = -10%, max=+63%) compared to SMR. The individual median average glycaemia during post-prandial periods generally decreases, with a median variation of -17 mg/dL (min = -87, max=+33) compared to SMR.

Conclusions: In this study, we show that teenagers who report meals in advance to their artificial pancreas benefit from a decrease of median glycaemic post-prandial peaks and an increase of the time in normal range. The possibility to report meals early could be encouraged by targeted patient education and customized reminders.

Volume 94

59th Annual ESPE (ESPE 2021 Online)

22 Sep 2021 - 26 Sep 2021

European Society for Paediatric Endocrinology 

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