ESPE Abstracts (2022) 95 P1-255

ESPE2022 Poster Category 1 Diabetes and Insulin (86 abstracts)

Initial results in the initiation of the hybrid closed-loop system in Spanish children with type 1 diabetes mellitus

María Hernández Herrero 1 , Pilar Terradas Mercader 2 & Ester Castellarnau Figueras 3


1Paediatric Endocrinology Department, Joan XXIII University Hospital, Tarragona, Spain; 2Paediatric Endocrinology Department, Pius Hospital, Valls, Spain; 3Paediatric Department, Joan XXIII University Hospital, Tarragona, Spain

Introduction: Tandem Control-IQ and Minimed 780G are advanced hybrid closed-loop pumps (HCL) that began to use in adults and children in our hospital in 2021. These systems are made up of a continuous interstitial glucose monitoring (CGM) system, the insulin infuser, and the algorithm that automatically adjusts insulin delivery based on real-time glucose levels. Patients only require carbohydrate counting to calculate boluses. The aim of our study was to compare glycemic control before and three months after the start of HCL therapy.

Materials and methods: In the Paediatric Endocrinology Department, Joan XXIII University Hospital of Tarragona we have a total of 100 patients with diabetes mellitus type 1 (DM1) between 0 and 18 years of which 26 use HCL pumps. A retrospective observational study was conducted comparing clinical and CGM data from the month prior to starting HCL therapy (T0) with data from the first three months (T1, T2, and T3).

Results: We studied a total of 26 patients with a median age of 12 years (8.6-14.8). Six (37.5%) were male. They were diagnosed of diabetes mellitus type 1 (DM1) at the age of 7.1 years (5-9.9) and currently have 4.4 years (2.3-5.7) of disease evolution. They have a BMI of 0.6 SD (-0.4-1). Nine (35%) patients previously received treatment with multiple doses of insulin (MDI) and seventeen (65%) pumps with suspension in prediction of hypoglycemia (PLGS). The results three months after the start are shown in the following table:

  T0 T3 T3-T0 p
Insuline dose (UI/kg/d) 0,8 0,9 0,1  
basal (%) 41,9 46,5 4,6  
HbA1c (%) 7,0 6,7 -0,3 0,031
Time in range, TIR (%) 61,5 72,0 10,5 <0,001
Time above range, TAR (%) 25,0 20,5 -4,5 <0,001
Time above range, TAR > 250mg/dl (%) 8,5 4,5 -4,0 0,006
Time below range, TBR (%) 1,0 2,0 1,0 0,317
Time below range, TBR < 54mg/dl (%) 0,0 0,0 0,0 0,081
Average glucose (mg/dl) 161,0 153,0 -8,0 0,005
Coefficient variation, CV (%) 34,0 37,0 3,0 0,066
Expressed values in median

Conclusions: HCL pumps significantly improve glycemic control both at the HbA1c and TIR levels, reducing TAR at the expense of slightly increasing the time in TBR without presenting severe hypoglycemia. These results are already observed in the first month and improve both the patients with previous treatment with MDI and with PLGS. Despite the short experience with this technology in our area, the results are positive and promising for improving the quality of life of patients with DM1.

Volume 95

60th Annual ESPE (ESPE 2022)

Rome, Italy
15 Sep 2022 - 17 Sep 2022

European Society for Paediatric Endocrinology 

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