scholarly journals One-year experience of hybrid closed-loop system in children and adolescents with type 1 diabetes previously treated with multiple daily injections: drivers to successful outcomes

2020 ◽  
Author(s):  
Goran Petrovski ◽  
Fawziya Al Khalaf ◽  
Judith Campbell ◽  
Fareeda Umer ◽  
Douha Almajaly ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Children And Adolescents ◽  
Closed Loop ◽  
Glucose Monitoring ◽  
Self Monitoring ◽  
Multiple Daily Injections ◽  
System Use ◽  
Previously Treated

Abstract Objective To evaluate the effect of a 1-year hybrid closed-loop (HCL) system on glycemic control in children and adolescents with type 1 diabetes (T1D) previously treated with multiple daily injections (MDI). Methods This was a 1-year observational study, as a continuation of the previous 3 months prospective study of pediatric patients with T1D conducted at Sidra Medicine in Qatar. The study enrolled individuals aged 7–18 years with T1D > 1 year, on MDI with self-monitoring of blood glucose or continuous glucose monitoring, with no prior pump experience, and with an HbA1c level < 12.5% (< 113 mmol/mol). After the first 3 months of HCL use, patients were followed at 6, 9 and 12 months, where HbA1c was obtained and pump data were collected. Results All 30 participants (age 10.24 ± 2.6 years) who initiated HCL completed 12 months of HCL system use in Auto Mode. The participants used the sensor 88.4 ± 6.5% of the time with Auto Mode usage 85.6 ± 7.4% during 12 months of HCL system use. HbA1c decreased from 8.2 ± 1.4% (66 ± 15.3 mmol/mol) at baseline, to 6.7 ± 0.5% (50 ± 5.5 mmol/mol) at 3 months (p = 0.02) and remained stable to 7.1 ± 0.6 (54 ± 6.6 mmol/mol) at 12 months (p = 0.02). TIR (70–180 mg/dL) increased from 46.9% at baseline to 71.9% at 1 month and remained above 70% during the 12 months of HCL use. Conclusion HCL system (MiniMed 670G) in children and adolescents previously treated with MDI significantly improves glycemic outcomes (HbA1c and Time in Ranges) immediately during the first month. This improved glycemic control was maintained over the 1 year following Auto Mode initiation.

1043-P: GoBolus Study: Impact of Faster Aspart on Glycemic Control in a Real-World Population with Type 1 Diabetes on Basal-Bolus Therapy as Multiple Daily Injections Using Flash Glucose Monitoring

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1043-P
Author(s):  
THOMAS DANNE ◽  
MATTHIAS AXEL SCHWEITZER ◽  
WINFRIED KEUTHAGE ◽  
STEFAN KIPPER ◽  
YASMIN KRETZSCHMAR ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Real World ◽  
Glucose Monitoring ◽  
World Population ◽  
Flash Glucose Monitoring ◽  
Multiple Daily Injections ◽  
Basal Bolus

scholarly journals Lower Daily Carbohydrate Intake is associated with Improved Glycemic Control in Adults with Type 1 Diabetes using a Hybrid Closed-Loop System

2020 ◽  
Author(s):  
Vera Lehmann ◽  
Thomas Zueger ◽  
Anna Zeder ◽  
Sam Scott ◽  
Lia Bally ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Closed Loop ◽  
Glucose Monitoring ◽  
Closed Loop System ◽  
Female Age ◽  
Time In Range ◽  
Design And Methods

<i>Objective</i> <p>To assess the association between daily carbohydrate (CHO) intake and glycemic control in adult hybrid closed-loop (HCL) users with type 1 diabetes mellitus (T1D).</p> <p><i>Research Design and Methods</i></p> <p>Mean individual daily CHO intake (MIDC) and deviation from MIDC (rMIDC; ≤80% low; 81-120% medium, >120% high CHO consumption) were compared with parameters of glycemic control assessed by continuous glucose monitoring (CGM). </p> <p><i>Results</i></p> <p>Records from 36 patients (26 male, 10 female; age 36.9±13.5y; HbA<sub>1c</sub> 7.1±0.9% [54±10mmol/mol]) provided 810 days of data (22.5±6.7 days per patient). Time in range (70-180mg/dL) for low, medium, and high CHO consumption was 77.4±15.4%, 75.2±16.7% and 70.4±17.8%, respectively (<i>p</i><0.001). Time above range (>180mg/dL) was 20.1±14.7%, 22.0±16.9% and 27.2±18.4%, respectively (<i>p</i><0.001). There was no between-group difference for time in hypoglycemia (<70mg/dL; <i>p</i>=0.50).</p> <p><i>Conclusions</i></p> Daily CHO intake was inversely associated with glycemic control in adults with T1D using a HCL system. Lower CHO intake may be a strategy to optimize glucose control in HCL users.

scholarly journals Successful Initiation of Hybrid Closed-Loop System Using Virtual Pump Training Program in a Teenager With Type 1 Diabetes Previously Treated with Multiple Daily Injections

2020 ◽  
pp. 193229682095075 ◽  
Author(s):  
Goran Petrovski ◽  
Judith Campbell ◽  
Douha Almajali ◽  
Fawziya Al Khalaf ◽  
Khalid Hussain
Keyword(s):  
Type 1 Diabetes ◽  
Training Program ◽  
Closed Loop ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia ◽  
Loop System ◽  
Technical Session ◽  
Closed Loop System ◽  
Multiple Daily Injections

Due to the coronavirus disease 2019 restrictions in providing diabetes services, we have developed an innovative pump training program, which consisted of technical session, pump training, one in-person practical session, and four consecutive online sessions (Skype Meet Now). A 13-year-old female patient with a 4-year history of type 1 diabetes (T1D) on multiple daily injections (MDI) with glycated hemoglobin 8.9%; 74 mmol/mol) initiated Minimed 670G system using the program. Time in range (70-180 mg/dL) of 39% and sensor glucose (SG) of 214±91 mg/dL (MDI with continuous glucose monitoring) increased to 69% in the first 2 weeks and reached 86% and SG of 140±40 mg/dL in the first month of auto mode initiation, without severe hypoglycemia or hyperglycemia. Virtual pump training program can be an effective tool to initiate a hybrid closed-loop system and to improve glycemic control in people with T1D on MDI.

scholarly journals Glycemic Control Improvement in Italian Children and Adolescents With Type 1 Diabetes Followed Through Telemedicine During Lockdown Due to the COVID-19 Pandemic

2020 ◽  
Vol 11 ◽  
Author(s):  
Barbara Predieri ◽  
Francesco Leo ◽  
Francesco Candia ◽  
Laura Lucaccioni ◽  
Simona F. Madeo ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Children And Adolescents ◽  
Real Time ◽  
Median Time ◽  
Statistical Significance ◽  
Glucose Monitoring ◽  
Total Daily Dose ◽  
Beneficial Effects

Background/ObjectiveTo minimize the wide spread of coronavirus disease (COVID-19) pandemic, Italy was placed in an almost complete lockdown state that forced people to “stay at home”. Aim of this study was to evaluate the effects of lockdown on glycemic control in children and adolescents with type 1 diabetes (T1D) followed through telemedicine.Subjects/MethodsThis observational study involved patients with T1D using the real-time continuous glucose monitoring (CGM) Dexcom G6®. Ambulatory glucose profile data from the 3-months before schools closure (November 26, 2019–February 23, 2020; T0) and from the 3-months of consecutive lockdown (February 24–May 18, 2020; T1) were compared.ResultsSixty-two children and adolescents (11.1 ± 4.37 years, 50% males) with T1D (median time disease 3.67 years) were enrolled in the study. Insulin total daily dose was unchanged, while time spent on physical activities was decreased (p&lt;0.0001). Despite the lack of statistical significance, median value of the glucose management indicator decreased from 7.4% to 7.25%. Glucose standard deviation (p&lt;0.0001) and coefficient of variation (p=0.001) improved across the study. Median time in range increased from 60.5% to 63.5% (p=0.008), time above range decreased from 37.3% to 34.1% (p=0.048), and time below range decreased from 1.85% to 1.45% (p=0.001).ConclusionsOverall, in our children and adolescents with T1D glycemic control improved during lockdown. Despite patients were confined to their homes and limited to exercise, our data suggest that the use of real-time CGM, the continuous parental management, and the telemedicine can display beneficial effects on T1D care.

scholarly journals Lower Daily Carbohydrate Intake is associated with Improved Glycemic Control in Adults with Type 1 Diabetes using a Hybrid Closed-Loop System

2020 ◽  
Author(s):  
Vera Lehmann ◽  
Thomas Zueger ◽  
Anna Zeder ◽  
Sam Scott ◽  
Lia Bally ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Closed Loop ◽  
Glucose Monitoring ◽  
Closed Loop System ◽  
Female Age ◽  
Time In Range ◽  
Design And Methods

<i>Objective</i> <p>To assess the association between daily carbohydrate (CHO) intake and glycemic control in adult hybrid closed-loop (HCL) users with type 1 diabetes mellitus (T1D).</p> <p><i>Research Design and Methods</i></p> <p>Mean individual daily CHO intake (MIDC) and deviation from MIDC (rMIDC; ≤80% low; 81-120% medium, >120% high CHO consumption) were compared with parameters of glycemic control assessed by continuous glucose monitoring (CGM). </p> <p><i>Results</i></p> <p>Records from 36 patients (26 male, 10 female; age 36.9±13.5y; HbA<sub>1c</sub> 7.1±0.9% [54±10mmol/mol]) provided 810 days of data (22.5±6.7 days per patient). Time in range (70-180mg/dL) for low, medium, and high CHO consumption was 77.4±15.4%, 75.2±16.7% and 70.4±17.8%, respectively (<i>p</i><0.001). Time above range (>180mg/dL) was 20.1±14.7%, 22.0±16.9% and 27.2±18.4%, respectively (<i>p</i><0.001). There was no between-group difference for time in hypoglycemia (<70mg/dL; <i>p</i>=0.50).</p> <p><i>Conclusions</i></p> Daily CHO intake was inversely associated with glycemic control in adults with T1D using a HCL system. Lower CHO intake may be a strategy to optimize glucose control in HCL users.

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