ESPE2022 Poster Category 1 Diabetes and Insulin (86 abstracts)
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:
|Insuline dose (UI/kg/d)||0,8||0,9||0,1|
|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.
15 Sep 2022 - 17 Sep 2022