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Sustained effectiveness of an advanced hybrid closed loop system in a cohort of children and adolescents with type 1 diabetes: a one-year real-world study

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posted on 2024-04-16, 18:24 authored by Stefano Passanisi, Giuseppina Salzano, Bruno Bombaci, Nicola Minuto, Marta Bassi, Riccardo Bonfanti, Francesco Scialabba, Enza Mozzillo, Francesca Di Candia, Sara Monti, Vanna Graziani, Claudio Maffeis, Claudia Anita Piona, Claudia Arnaldi, Davide Tosini, Barbara Felappi, Rosalia Roppolo, Angela Zanfardino, Maurizio Delvecchio, Donatella Lo Presti, Elena Calzi, Carlo Ripoli, Roberto Franceschi, Petra Reinstadler, Ivana Rabbone, Giulio Maltoni, Angela Alibrandi, Stefano Zucchini, Marco Marigliano, Fortunato Lombardo

Objective. To investigate glucose metrics and identify potential predictors of the achievement of glycemic outcomes in children and adolescents during their first 12 months of MiniMed™ 780G use. Research design and methods. In this multicenter, longitudinal, real-world study, 368 children and adolescents with type 1 diabetes starting SmartGuard technology between June 2020 and June 2022 were recruited. Ambulatory glucose profile data were collected during a 15-day run-in period (baseline), two weeks after automatic mode activation, and every 3 months. The influence of covariates on glycemic outcomes after 1 year of Minimed™ 780G use was assessed. Results. After 15 days of automatic mode use, all glucose metrics improved compared to baseline (p<0.001), except for time below range and coefficient of variation (p=0.113 and p=0.330, respectively). After one year, time in range (TIR) remained significantly higher than at baseline (75.3% vs 62.8%, p<0.001). The mean glycated hemoglobin over the study duration was lower than the previous year (6.9 ± 0.6% vs 7.4 ± 0.9%, p<0.001). Time spent in tight range (70-140 mg/dl) was 51.1% and glycemia risk index was 27.6. Higher TIR levels were associated with a reduced number of automatic correction boluses (p<0.001), fewer SmartGuard exits (p=0.021), and longer time in automatic mode (p=0.030). Individuals with baseline HbA1c > 8% showed more relevant improvement in TIR levels (from 54.3% to 72.3%). Conclusions. Our study highlights the sustained effectiveness of Minimed™ 780G among youths with T1D. Findings suggest that even children and adolescents with low therapeutic engagement may benefit from SmartGuard technology.

Funding

Fundings and Assistance: The present study was not funded.

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