How does a predictive low glucose suspend (PLGS) system tackle pediatric lifespan challenges in diabetes treatment? Real world data analysis

Abstract

Objectives: The aim of the study was to assess the benefits of a predictive low glucose suspend (PLGS) system in real-life in children and adolescents with type 1 diabetes of different age and age-related clinical challenges.Methods: Real life retrospective and descriptive analysis included 44 children (26 girls) with type 1 diabetes who were introduced to PLGS system. We divided them in three age groups: I (3-6 years old, n = 12), II (7-10 y/o, n = 16), III (11-19 y/o, n = 16). All children and their caregivers received unified training in self-management during PLGS therapy. Patients' data included: age, HbA1C levels, sex. While from the CGM metric, we obtained: time of sensor use (SENSuse), time in range (TiR): in, below and over target range and average blood glycemia (AVG), insulin suspension time (INSsusp).Results: SENSuse was 93% in total, with 92%, 94%, and 87% in age groups I, II, III, respectively. In total the reduction of mean HbA1C from 7.61% to 6.88% (P < .05), while for the I, II, and III it was 7.46% to 6.72%, 6.91% to 6.41%, and 8.46 to 7.44%, respectively (P < .05). Although we observed a significant reduction of HbA1C, the time below target range was minimal. Specific findings included: group I-longest INSsusp (17%), group II-lowest glycemic variability (CV) (36%), and group III-highest AVG (169 mg/dL). There was a reverse correlation between suspend before low and age (−0.32, P < .05). In group I CV reduced TiR in target range (TiRin) (−0.82, P < .05), in group II use of complex boluses increased TiRin (0.52, P < .05). In group III higher CV increased HbA1C (0.64, P < .05) while reducing TiRin (−0.72, P < .05).Conclusions: PLGS is a suitable and safe therapeutic option for children with diabetes of all age and it is effective in addressing age-specific challenges. PLGS improves glycemic control in children of all age, positively affecting its different parameters. K E Y W O R D Sdiabetes, insulin pumps, technology

Predictive Low Glucose Suspend Algorithm in Real Life: A Five-Year Follow-Up Retrospective Analysis

“…median follow-up of 12 months (6-18), but the reduction of HbA1c was not significant (by 0.1 percentage point). On the other hand, similar decrease in HbA1c levels (from 7.61% to 6.88%, P < .05) was observed in a study of Gaweł et al, 15 conducted in a pediatric population with a shorter follow-up period (10.8 months). In our study the follow-up period was long enough to exclude the greater therapeutic adherence observed in the first few months of using a new device, because of higher interest for the device and due to more intensive educational therapy.…”

The Impact of Hypo- and Hyperglycemia on Cognition and Brain Development in Young Children with Type 1 Diabetes

“…The protective effect of PLGS in the Medtronic 640G was also shown in a randomized controlled study in children and adolescents ( n = 100) who endured a significantly reduced number and duration of hypoglycemic events [59]. Similar results were also shown in a recent study in very young children (3–6 years of age, n = 44), in whom the PLGS enabled reaching a time in range (TIR) of 82% [60].…”

Newest Diabetes-Related Technologies for Pediatric Type 1 Diabetes and Its Impact on Routine Care: a Narrative Synthesis of the Literature

“…One of the most assertive advances in diabetes technology was the launching of pumps with predictive low glucose suspension (PLGS) system and turned diabetes management into a suitable and safe therapeutic option, especially for very young children with diabetes to prevent risk of severe hypoglycemia [18]. And it also seems to be effective in addressing age-specific challenges and able to improve glycemic control in children of all ages [81].…”

“…Use of the newest insulin pumps was associated with lower mean HbA1c values in several studies [18][19][20][21][22][23]. Their use was also related to a higher treatment satisfaction and better health perception, as well as a significant decline of overall diabetes burden at follow-up than those on MDI Sensor-augmenting pump therapy use adds value to treatment satisfaction without correlation with the duration of the sensors use [25].…”