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)|
|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.
15 Sep 2022 - 17 Sep 2022