Background: The aim of this multicenter observational real-world study was to investigate glycemic outcomes in children and adolescents with type 1 diabetes over the first six-month use of MiniMed™ 780G. Secondary objective was to evaluate demographic and clinical factors that may be significantly associated with the achievement of therapeutic goals. Methods: Demographic, anamnestic, and clinical data of study participants were collected at time of enrolment. Data on ambulatory glucose profile were acquired at 3 and 6 months after activating Auto Mode. Aggregated glucose metrics and device settings of the entire study period were analyzed to identify predictors of optimal glycemic control, assessed by the concomitant achievement of time in range (TIR) > 70%, coefficient of variation (CV) < 36%, glucose management index (GMI) < 7%, and time below range (TBR) < 4%. Results: Our study cohort consisted of 111 children and adolescents (54.1% female) aged 7-18 years. All the most relevant clinical targets were achieved according to recommendations from the International Consensus both at 3 and 6 months. When considering aggregated data, primary goals in terms of TIR, CV, GMI, and TBR were achieved respectively by 72.1%, 74.8%, 68.5%, and 74.8% of participants. Additionally, 44 individuals (39.6%) concomitantly addressed all the above clinical targets. Regression analysis revealed that older age, briefer duration of disease, and shorter active insulin time were significant predictors of optimal glucose control. Comparing two groups of individuals stratified according to the HbA1c mean value in the year preceding MiniMed™ 780G use, achieving glycemic targets was observed in the subgroup with lower HbA1c. Conclusions: Our study highlights the effectiveness and safety of MiniMed™ 780G in the pediatric population. More extensive and personalized training on advanced hybrid closed loop use should be considered for younger people and those with long disease duration.
MiniMed™ 780G six-month use on children and adolescents with type 1 diabetes: clinical targets and predictors of optimal glucose control
Piona, Claudia;Maffeis, Claudio;
2023-01-01
Abstract
Background: The aim of this multicenter observational real-world study was to investigate glycemic outcomes in children and adolescents with type 1 diabetes over the first six-month use of MiniMed™ 780G. Secondary objective was to evaluate demographic and clinical factors that may be significantly associated with the achievement of therapeutic goals. Methods: Demographic, anamnestic, and clinical data of study participants were collected at time of enrolment. Data on ambulatory glucose profile were acquired at 3 and 6 months after activating Auto Mode. Aggregated glucose metrics and device settings of the entire study period were analyzed to identify predictors of optimal glycemic control, assessed by the concomitant achievement of time in range (TIR) > 70%, coefficient of variation (CV) < 36%, glucose management index (GMI) < 7%, and time below range (TBR) < 4%. Results: Our study cohort consisted of 111 children and adolescents (54.1% female) aged 7-18 years. All the most relevant clinical targets were achieved according to recommendations from the International Consensus both at 3 and 6 months. When considering aggregated data, primary goals in terms of TIR, CV, GMI, and TBR were achieved respectively by 72.1%, 74.8%, 68.5%, and 74.8% of participants. Additionally, 44 individuals (39.6%) concomitantly addressed all the above clinical targets. Regression analysis revealed that older age, briefer duration of disease, and shorter active insulin time were significant predictors of optimal glucose control. Comparing two groups of individuals stratified according to the HbA1c mean value in the year preceding MiniMed™ 780G use, achieving glycemic targets was observed in the subgroup with lower HbA1c. Conclusions: Our study highlights the effectiveness and safety of MiniMed™ 780G in the pediatric population. More extensive and personalized training on advanced hybrid closed loop use should be considered for younger people and those with long disease duration.
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