Paediatric and Adolescent Diabetes Unit (PADU), Department of Paediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Department of Paediatrics, Faculty of Medicine, Misr University of Science and Technology (MUST), Giza, Egypt.
Diabetes Obes Metab. 2024 Nov;26(11):4916-4923. doi: 10.1111/dom.15891. Epub 2024 Sep 9.
To map the glycaemic variabilities and insulin requirements across different phases of the menstrual cycle and assess the efficacy and performance of the MiniMed 780G system on mitigating glycaemic variabilities during phases of the menstrual cycle.
A pilot study recruiting 15 adolescent and young adult females with type 1 diabetes was conducted. Only females with regular spontaneous menstruation were enrolled in the current study. Phases of each menstrual cycle were determined as either follicular phase or luteal phase. The study analysed continuous glucose monitoring metrics during two study periods: the open loop period (OLP) and the advanced hybrid closed-loop (AHCL) period; each period lasted 3 consecutive months.
During the OLP, the mean time in range (TIR) significantly decreased during the luteal phase compared with the follicular phase (65.13% ± 3.07% vs. 70.73% ± 2.05%) (P < .01). The mean time above range significantly increased from 21.07% ± 2.58% during the follicular phase to 24.87% ± 2.97% during the luteal phase (P < .01). After initiating the AHCL period, TIR was comparable during both phases of the menstrual cycle (P = .72), without increasing the time spent below 70 mg/dL (P > .05). Regarding insulin delivery during the AHCL period, the percentage of Auto basal and Auto correction delivered by the algorithm increased by 13.55% and 30.6%, respectively (P < .01), during the luteal phase.
The fully automated adaptive algorithm of the MiniMed 780G system mitigated menstrual cycle-dependent glycaemic variability, successfully attaining the recommended glycaemic outcomes with a TIR greater than 70% throughout the entire menstrual cycle.
描绘月经周期不同阶段的血糖变异性和胰岛素需求,并评估 MiniMed 780G 系统在缓解月经周期各阶段血糖变异性方面的疗效和性能。
进行了一项招募 15 名患有 1 型糖尿病的青少年和年轻成年女性的试点研究。仅招募月经周期自发且规律的女性参与本研究。每个月经周期的阶段分为卵泡期或黄体期。研究分析了两个研究期间连续血糖监测指标:开环期(OLP)和高级混合闭环期(AHCL);每个时期持续 3 个月。
在 OLP 期间,黄体期的平均血糖达标时间(TIR)显著低于卵泡期(65.13%±3.07% vs. 70.73%±2.05%)(P<.01)。平均血糖高于目标范围的时间从卵泡期的 21.07%±2.58%显著增加到黄体期的 24.87%±2.97%(P<.01)。在开始 AHCL 期后,两个月经周期的 TIR 相当(P=.72),且没有增加血糖低于 70mg/dL 的时间(P>.05)。在 AHCL 期间,算法提供的自动基础率和自动调整率分别增加了 13.55%和 30.6%(P<.01)。
MiniMed 780G 系统的全自动自适应算法减轻了月经周期相关的血糖变异性,成功实现了整个月经周期 TIR 大于 70%的推荐血糖目标。