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美敦力780G™ 先进混合闭环系统在埃及不同年龄组1型糖尿病患者中的性能:来自真实用户的证据

MiniMed 780G™ advanced hybrid closed-loop system performance in Egyptian patients with type 1 diabetes across different age groups: evidence from real-world users.

作者信息

Elbarbary Nancy Samir, Ismail Eman Abdel Rahman

机构信息

Department of Pediatrics, Faculty of medicine, Ain shams University, 25 Ahmed Fuad St. Saint Fatima, Cairo, 11361, Egypt.

Department of Clinical Pathology, Faculty of medicine, Ain shams University, Cairo, Egypt.

出版信息

Diabetol Metab Syndr. 2023 Oct 17;15(1):205. doi: 10.1186/s13098-023-01184-w.

Abstract

BACKGROUND

Advanced hybrid closed loop (AHCL) system provides both automated basal rate and correction boluses to keep glycemic values in a target range.

OBJECTIVES

To evaluate the real-world performance of the MiniMed™ 780G system among different age groups of Egyptian patients with type 1diabetes.

METHODS

One-hundred seven AHCL system users aged from 3 to 71 years were enrolled. Data uploaded by patients were aggregated and analyzed. The mean glucose management indicator (GMI), percentage of time spent within glycemic ranges (TIR), time below range (TBR) and time above range (TAR) were determined.

RESULTS

Six months after initiating Auto Mode, patients spent a mean of 85.31 ± 22.04% of the time in Auto Mode (SmartGuard) and achieved a mean GMI of 6.95 ± 0.58% compared with 7.9 ± 2.1% before AHCL initiation (p < 0.001). TIR 70-180 mg/dL was increased post-AHCL initiation from 63.48 ± 10.14% to 81.54 ± 8.43% (p < 0.001) while TAR 180-250 mg/dL, TAR > 250 mg/dL, TBR < 70 mg/dL and TBR < 54 mg/dL were significantly decreased (p < 0.001). After initiating AHCL, TIR was greater in children and adults compared with adolescents (82.29 ± 7.22% and 83.86 ± 9.24% versus 78.4 ± 7.34%, respectively; p < 0.05). The total daily dose of insulin was increased in all age groups primarily due to increased system-initiated insulin delivery including auto correction boluses and basal insulin.

CONCLUSIONS

MiniMed 780G system users across different age groups achieved international consensus-recommended glycemic control with no serious adverse effects even in challenging age group as children and adolescents.

摘要

背景

先进的混合闭环(AHCL)系统可提供自动基础率和校正大剂量胰岛素注射,以将血糖值维持在目标范围内。

目的

评估美敦力™780G系统在埃及1型糖尿病不同年龄组患者中的实际使用效果。

方法

招募了107名年龄在3至71岁之间的AHCL系统使用者。汇总并分析患者上传的数据。确定平均血糖管理指标(GMI)、血糖处于目标范围内的时间百分比(TIR)、低于目标范围的时间(TBR)和高于目标范围的时间(TAR)。

结果

开启自动模式6个月后,患者平均85.31±22.04%的时间处于自动模式(智能卫士),平均GMI为6.95±0.58%,而在启动AHCL之前为7.9±2.1%(p<0.001)。启动AHCL后,血糖在70-180mg/dL范围内的TIR从63.48±10.14%增加到81.54±8.43%(p<0.001),而血糖在180-250mg/dL、大于250mg/dL、低于70mg/dL和低于54mg/dL范围内的TAR显著降低(p<0.001)。启动AHCL后,儿童和成人的TIR高于青少年(分别为82.29±7.22%和83.86±9.24%,而青少年为78.4±7.34%;p<0.05)。所有年龄组的每日胰岛素总剂量均增加,主要是由于系统启动的胰岛素输送增加,包括自动校正大剂量胰岛素注射和基础胰岛素。

结论

不同年龄组的美敦力780G系统使用者均实现了国际共识推荐的血糖控制,即使在儿童和青少年等具有挑战性的年龄组中也没有严重不良反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/316f/10580510/36b12eeac39b/13098_2023_1184_Fig1_HTML.jpg

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