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Carbohydrate Tolerance Threshold for Unannounced Snacks in Children and Adolescents With Type 1 Diabetes Using an Advanced Hybrid Closed-Loop System

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posted on 06.05.2022, 13:04 by Gianluca Tornese, Claudia Carletti, Manuela Giangreco, Daniela Nisticò, Elena Faleschini, Egidio Barbi
Objective To find a carbohydrate tolerance threshold for unannounced snacks to avoid the 2-hours increase in glycemia (∆BG) ≥50 mg/dl in advanced hybrid closed-loop (a-HCL) users.

Research Design and Methods Fourteen children and adolescents with Type 1 Diabetes (7 females, mean age 14.5±3.6 years), users of Medtronic Minimed™ 780G, participated in the study. For 12 days, they did not perform insulin bolus before breakfasts, with defined different quantities and types of CHO, with or without fats, performing blood glucose (BG) before and 2 hours after the meal.

Results A cut-off of 19.8 gr of total carbohydrates was found to determine a ∆BG of 50 mg/dL. BG never exceeded 250 mg/dL. Mean TIR was ≥70% in the 2 hours following each snack.

Conclusions Unannounced snacks up to 20 grams of CHO can avoid ∆BG ≥50 mg/dL in Minimed™ 780G users, although unannounced meals up to 30 grams of CHO are safe.


This work was supported by ISPAD-JDRF Fellowship 2017 to Dr. Gianluca Tornese.