ESPE2023 Poster Category 1 Diabetes and Insulin (55 abstracts)
MiniMed 780G Advanced Hybrid Closed Loop System Outcomes According to Pubertal Status - Awesome Study Group Real-Life Experience
Marianna Rachmiel 1,2 , Yael Lebenthal 3,2 , Kineret Kineret Mazor-Aronovitch 4,5,2 , Avivit Brener 3,2 , Noah Levek 4,5 , Talia Polishuk-Yakobi 1 , Tal Tal Ben 6,2 , Shirli Abiri 6,2 , Zohar Landau 4,7 & Orit Pinhas-Hamiel 4,5,2
1Shamir (Assaf Harofeh) Medical Center, Be'er Yaakov, Israel. 2Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 3Dana-Dwek Children’s Hospital, Tel Aviv, Israel. 4Maccabi Health Care Services, Ra'anana, Israel. 5Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Ramat-Gan, Israel. 6E. Wolfson Medical Center, Holon, Israel. 7Ben-Gurion University of the Negev, Beer Sheva, Israel
Background and aims: Achieving good glycemic control is a major challenge for adolescents with type 1 diabetes (TID). The introduction of the MiniMed 780G system, an advanced hybrid closed-loop (AHCL), that enables an automatic correction of insulin, gave hope for improved glycemic outcomes in adolescents. We assessed specific characteristics associated with glycemic measures in youth with T1D switching to Minimed 780G.
Methods: This retrospective observational real-life multi-center study from the AWeSoMe Group assessed continuous glucose monitoring (CGM) metrics of 22 patients (59% females, median age 13.9 [IQR 11,18] years), from a high socioeconomic background. CGM metrics were recorded for two-week periods prior to AHCL, after 1, 3, 6 months, and at the end of follow-up (median 10.9 [IQR 5.4, 17.4] months). Delta-variables (∆) were calculated as the difference between the end of follow-up and baseline.
Results: TIR70-180mg/dL increased from 65% [52,72] to 75% [63,80], P=0.008, from baseline to end. TAR>180mg/dL, decreased from 28% [20,46] to 22% [14,35], P=0.047. Advanced pubertal stage was correlated with less improvement in ∆TAR>180mg/dL, r= 0.47, P=0.05, and less CGM usage r= -0.57, P=0.05. A longer disease duration was associated with less improvement in ∆TAR180-250mg/dL, r= 0.48, P=0.05. Lower pump site change frequency was associated with higher GMI, r= 0.5, P=0.03, and lower TIR70-180mg/dL r= -0.52, P=0.08.
Conclusion: The use of AHCL enabled improvements in TIR70-180mg/dL in youth with T1D. More advanced pubertal stages, longer disease duration, and less compliance were associated with less improvement, stressing the need for continuous support and re-education in this age group.
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