ESPE2022 Poster Category 1 Diabetes and Insulin (86 abstracts)
1Koç University, Istanbul, Turkey; 2Koç University Hospital, Istanbul, Turkey
Introduction: Automated insulin delivery systems provide significant improvement in the time in range(TIR) centered diabetes care. This study analyzes the real-word performance of Minimed 780G™system-Advanced Hybrid Closed Loop(AHCL) in children from a single center.
Methods: Of the 93 children started to use AHCL between January 2021 and April 2022, 64 whose data could be accessed were included. 3,6,9 and 12 month-data were analyzed in terms of the proportion of users achieving recommended glucose management indicator (GMI<7.0%), TIR (70-180 mg/dL >70%) and time below range(TBR<5%) goals. In a second analysis, data of the children previously treated with multiple daily injections (MDI) (group-1, n:23) and with insulin pumps (group-2, n:39) were analyzed regarding glycemic profile before and after AHCL.
Results: At the baseline mean TIR, TBR<70 and HbA1c were 72.7±11.7%, 4±4.5% and 7.3±0.9% while they were 80.1±8.7%, 3.4±3% and 6.8±0.8% respectively at 3-month. TIR increased by 7.4% at 3-month, compared to baseline (P:0.001). At 3-month, 88% of the participants achieved TIR>70% goal, 80.4% achieved TIR >70% and GMI<7% and TBR<5% goals. No significant difference was noted between 3-6-9 and 12th month TIR percentages (80%, 79%, 81%, 82%, p:0.122). In group-1 and group-2, the increase in TIR from baseline to 3-month were 13%, 6%, respectively (P1:0.01; p2:0.017). The increase in TIR at 3-month in Group-1 was significantly higher than in Group-2 (P 0.014).
Baseline(n:33) | 3-month(n:58) | 6-month(n: 41) | 9-month (n:34) | 12-month (n:24) | |
Automode(%) | N/A | 96.3±8.1 | 95.6±6.9 | 97±4 | 95.2±7.7 |
TIR(%) | 72.7±11.7 | 80.1±8.7 | 79.1±9.2 | 81.4±7.8 | 82.1±7 |
TAR>180(%) | 18.8±8.4 | 13.8±6.5 | 15±6.6 | 13.5±5.3 | 13.3±5.3 |
TAR >250(%) | 4.2±4.6 | 2.6±2.8 | 2.8±2.7 | 2.5±2.8 | 2±2.2 |
TBR<70(%) | 4±4.5 | 3.4±3 | 2.4±2.2 | 2.2±1.7 | 2.5±1.8 |
CV(%) | 33.7±6.1 | 33.7±5.1 | 33±4.2 | 32.7±6 | 31.8±7.3 |
GMI(%) | N/A | 7±3.8 | 6.6±0.2 | 6.5±0.2 | 6.5±0.28 |
HbA1c (%) | 7.3±0.9 | 6.8±0.8 | 6.8±0.4 | 7.1±0.8 | 6.8±0.5 |
TIR of>%70 | 60 | 87.7 | 82.9 | 94.1 | 95.8 |
3 goals (TIR>70%+GMI<7%+TBR<5) | N/A | 80.4 | 77.5 | 85.3 | 87 |
*Linear regression model was used in the analysis of the data |
Conclusion: AHCL is a reliable system for achieving and maintaining glycemic goals, mainly TIR >70%goal in children. The improvement is more prominent in the children previously treated with MDI.