Glycemic control during Ramadan fasting in adolescents and young adults with type 1 diabetes on MiniMed™ 780G advanced hybrid closed‑loop system: A randomized controlled trial

Elbarbary, Nancy; Ismail, Eman Abdel Rahman

doi:10.1016/j.diabres.2022.110045

Cited by 13 publications

(17 citation statements)

References 49 publications

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“…The novelty of this study is the longest, 1 year follow-up of the AHCL use in auto-mode in the pediatric population combined with the assessment of BMI z-score changes. Another strength of this investigation is the youngest observed until now (mean age: 9.88 ± 2.44) ( 34 – 45 ) cohort characterized by good glycemic control parameters. Nevertheless we acknowledge the limitations, which include the lack of the assessment of the amount of carbohydrates consumed as well as no detailed dietary evaluation at baseline and follow up that would allow us to note any changes in eating behaviors.…”

Section: Discussionmentioning

confidence: 93%

“…We describe stable BMI z-scores of children and adolescents with T1D using the AHCL system during a 1-year follow up which is the first such long observation (34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45). Similar results, also for a pediatric cohort of individuals with T1D, were obtained by Tornese et al, who reported no change in BMI zscore after 6 months of insulin treatment using either the hybrid closed-loop (Minimed 670G) or AHCL (Minimed 780G) systems.…”

Section: Discussionmentioning

confidence: 99%

“…Noteworthy, our patients were characterized by more optimal glycemic control (lower GMI 6.48% vs 7.1% and higher TIR 81.16% vs 72%) after 6 months of AHCL use with a similar time spent in auto-mode (96.62% vs 96) and percent of sensor use (94.04% vs 92%) (36). Among the growing number of studies evaluating the AHCL Minimed 780G system these are to our knowledge the only two investigating the associations with BMI z-score (34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45). Former studies that observed BMI in children with T1D using insulin pumps other than AHCL showed not unequivocal results although the latest metaanalysis suggested no change in body mass (28, 29).…”

Section: Discussionmentioning

confidence: 99%

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Body mass index, basal insulin and glycemic control in children with type 1 diabetes treated with the advanced hybrid closed loop system remain stable - 1-year prospective, observational, two-center study

et al. 2022

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BackgroundInformation on the influence of insulin treatment using advanced hybrid closed loop systems (AHCL) on body weight of young patients with type 1 diabetes (T1D) is scarce. The aim of this study was to observe whether there were any changes in body mass index (BMI) of children and adolescents with T1D treated using the Medtronic Minimed 780G AHCL after 1 year of follow up and to analyze potential associations between these changes and the insulin doses.Materials and methodsFor 50 children and adolescents (age 5.4-16.8 years, 24 (48%) boys, T1D for 3.9 ± 2.56 years) using an AHCL system anthropometric and AHCL data were collected prospectively. BMI Z-scores and two-week AHCL records obtained after AHCL enrollment were compared with data after 6 months and also 1 year after starting AHCL.ResultsThe BMI Z-score of the patients at 1 year follow-up did not change from time of AHCL initiation (0.51 ± 2.79 vs 0.57 ± 2.85, p>0.05). There was a slight increase in total daily insulin per kg of body weight (0.67 ± 0.21 U/kg vs 0.80 ± 0.21 U/kg, p <0.001), but the percent of basal insulin was unchanged (34.88 ± 6.91% vs 35.08 ± 6.30%, p>0.05). We observed also no change (AHCL start vs after 1 year) in glycemic control parameters: average sensor glucose (131.36± 11.04 mg/dL vs 132.45 ± 13.42 mg/dL, p>0.05), coefficient of variation (34.99± 5.17% vs 34.06 ± 5.38%, p>0.05), glucose management indicator (6.45 ± 0.26% vs 6.48 ± 0.32%, p>0.05), and time spent in the range of 70–180 mg/dL (79.28 ± 8.12% vs 80.40 ± 8.25%, p>0.05).ConclusionDuring the 1 year of follow-up the BMI of children and adolescents with T1D treated with an AHCL system remained stable. Although there was a slight increase in the total daily insulin dose, the percent of basal insulin was unchanged. The patients maintained recommended glycemic control.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Body mass index, basal insulin and glycemic control in children with type 1 diabetes treated with the advanced hybrid closed loop system remain stable - 1-year prospective, observational, two-center study

et al. 2022

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“…A prospective study assessed the safety, effectiveness, and optimization of an advanced hybrid closed loop (AHCL) system on glycemic metrics and the level of hypoglycemia in T1DM patients who wished to fast Ramadan. 27 Forty-two T1DM patients (mean age 15.2 years) using the AHCL system were divided into two groups (each n = 21): the intervention group who adjusted AHCL settings and the control group who kept the same settings as before Ramadan. The most aggressive system settings among the control group consisting of a 100 mg/dL glucose target, active insulin time of 2 hour, and bolus increment maintained exceptional glycemia with TIR reaching 82.0%, TAR more than 180 mg/dL of 12.1% without an increase in hypoglycemia (TBR 3.0%), all of which were nonsignificant in comparison to the intervention group.…”

Section: Resultsmentioning

confidence: 99%

“…There was a large interest in studies involving technology during Ramadan fasting. 9,[23][24][25][26][27][28][29] These studies are summarized in ►Table 3. The highlights of these studies are discussed briefly below.…”

Section: Diabetes Technology In Ramadanmentioning

confidence: 99%

Ramadan Fasting and Diabetes (2022): The Year in Review

Hafidh

Besheya

Elmehdawi

et al. 2023

Journal of Diabetes and Endocrine Practice

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Objectives The literature on the impact of Ramadan fasting (RF) on metabolic control and health in people with diabetes is widely spread in many journals making it not readily accessible to those interested in the subject. We aimed to provide a narrative overview of the global literature production in 1 year (2022) on diabetes and RF. Materials and Methods It is a narrative, non-systematic review of the international literature from a single major medical online database (i.e., PubMed) in one calendar year (2022). Relevant literature was narrated in a concise thematic account. Results Themes emerged from the review of the literature on RF published in 2022, including a couple of studies on the epidemiology of fasting in the real world by adults and children. Three studies involved some pathophysiological observations of metabolic and other biochemical markers. Several studies assessed the use and safety of different pharmacological therapeutic agents. Certain sulfonylureas, such as modified-release gliclazide, were considered safer than other sulfonylureas. Newer basal insulin analogs were studied in different geographical and socioeconomic settings (Gulf vs. South East Asia). The role of diabetes technology in Ramadan was the focus of several studies of insulin pumps and monitoring. Special themes were high-risk groups, pregnancy, acute complications, postbariatric surgery, and COVID-19 in Ramadan. Few studies examined the safety of sodium-glucose co-transporter-2 inhibitors as a class and individually during RF. Professional and patient perspectives released in 2022 included updated guidelines for adults and adolescents. Conclusions In 2022's medical literature, RF and diabetes continue to address epidemiology, the burden of diabetes care on fasting patients, and discussions of concerns of patients and healthcare professionals. Risk stratification and issues of high-risk patients are still in focus for children, adolescents, and adults. Approaches to effective management still gather evidence for newer pharmacological agents and diabetes technology.

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Safety, Metabolic and Psychological Outcomes of Medtronic MiniMed 780G™ in Children, Adolescents and Young Adults: A Systematic Review

Passanisi,

Lombardo,

Mameli

et al. 2023

Diabetes Ther

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The MiniMed™ 780G is a second-generation automated insulin delivery system that implements a modified proportional–integral–derivative algorithm with some features of an MD-Logic artificial pancreas algorithm. The system may deliver automatic correction boluses up to every 5 min, and it allows the user to choose between three glucose target setpoints (100, 110 and 120 mg/dL). We aimed to review the current evidence on this device in children, adolescents, and young adults living with type 1 diabetes. We screened 783 papers, but only 31 manuscripts were included in this review. Data on metabolic outcomes show that this system is safe as regards severe hypoglycaemia and diabetic ketoacidosis. The glycated haemoglobin may drop to levels about 7%, with CGM reports showing a time in range of 75–80%. The time above range and the time below range are within the recommended target in most of the subjects. Few studies evaluated the psychological outcomes. This system seems to be more effective than the first-generation automated insulin delivery systems. The MiniMed™ 780G has been associated with an improvement in sleep quality in subjects living with diabetes and their caregivers, along with an improvement in treatment satisfaction. Psychological distress is as reduced as the glucose control is improved. We also discuss some case reports describing particular situations in clinical practice. Finally, we think that data show that this system is a further step towards the improvement of the treatment of diabetes as concerns both metabolic and psychological outcomes.

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Glycemic control during Ramadan fasting in adolescents and young adults with type 1 diabetes on MiniMed™ 780G advanced hybrid closed‑loop system: A randomized controlled trial

Cited by 13 publications

References 49 publications

Body mass index, basal insulin and glycemic control in children with type 1 diabetes treated with the advanced hybrid closed loop system remain stable - 1-year prospective, observational, two-center study

Body mass index, basal insulin and glycemic control in children with type 1 diabetes treated with the advanced hybrid closed loop system remain stable - 1-year prospective, observational, two-center study

Ramadan Fasting and Diabetes (2022): The Year in Review

Safety, Metabolic and Psychological Outcomes of Medtronic MiniMed 780G™ in Children, Adolescents and Young Adults: A Systematic Review

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