Borella Nicolò Diego, Ferramosca Antonio, Castagna Giona, Ippolito Silvia, Ceresoli Sara, Taverna Antonio, Sonzogni Beatrice, Trevisan Roberto, Lepore Giuseppe
Unit of Endocrine Diseases and Diabetology, Department of Medicine, ASST Papa Giovanni XXIII, Piazza OMS, 1, 24127, Bergamo, Italy.
Control Systems and Automation Laboratory, Department of Management, Information and Production Engineering, University of Bergamo, Bergamo, Italy.
Acta Diabetol. 2024 Nov 22. doi: 10.1007/s00592-024-02397-9.
Advanced hybrid closed loop (AHCL) systems currently represent the most advanced modality of insulin therapy.
To compare the night-time (from 00 to 07 a.m.) effectiveness in achieving recommended glycemic targets of three different AHCL systems in adults with type 1 diabetes (T1D).
We retrospectively evaluated 55 adults with T1D (mean age 41 ± 16 years, male 40%, diabetes duration 19.4 ± 11.4 years, BMI 24.1 ± 4.1 kg/m) with similar glycemic control (GMI 7.0-7.4%). Twenty-two participants were using the Minimed 780G system, 18 the Tandem t:slim X2 with Control-IQ system and 15 the DBLG1 system. Continuous glucose monitoring derived metrics and insulin requirement of 14 consecutive nights were analyzed.
All three groups achieved the recommended mean TIR > 70%, mean TBR < 4%, and mean CV < 36% with a similar insulin requirement (Minimed 780G system: TIR 73.9 ± 11.2%, TBR 0.9 ± 1.2%, CV 29 ± 6.7%; Tandem t:slim X2 with Control-IQ system: TIR 74.1 ± 11.1%, TBR 1.1 ± 1.0%, CV 34.5 ± 6.6%; DBLG1 System TIR 71.7 ± 11.3%, TBR 1.4 ± 3.7%, CV 32.4 ± 7.1%). Tight TIR% (70-140 mg/dl) was significantly higher (p < 0.01) in the Tandem t:slim X2 with Control-IQ group (51.5 ± 9.8%) when compared to Minimed 780G group (42.1 ± 13.7%) and DBLG1 System (40.1 ± 10.5%). In all three groups the insulin infusion similarly decreased from midnight to 05.00 am and then increased.
All the three AHCL systems achieved the recommended TIR, TBR and CV without difference in insulin requirement. The Tandem Control-IQ system obtained a higher tight TIR.
先进的混合闭环（AHCL）系统目前代表了胰岛素治疗的最先进模式。
比较三种不同的AHCL系统在1型糖尿病（T1D）成人患者中实现推荐血糖目标的夜间（凌晨0点至7点）有效性。
我们回顾性评估了55例T1D成人患者（平均年龄41±16岁，男性占40%，糖尿病病程19.4±11.4年，BMI 24.1±4.1kg/m²），他们具有相似的血糖控制水平（糖化血红蛋白指数[GMI]为7.0 - 7.4%）。22名参与者使用美敦力780G系统，18名使用带有Control-IQ系统的丹德姆t:slim X2，15名使用DBLG1系统。分析了连续14个晚上的持续葡萄糖监测得出的指标和胰岛素需求量。
所有三组均达到了推荐的平均血糖达标时间（TIR）>70%，平均血糖低于目标时间（TBR）<4%，平均血糖波动幅度（CV）<36%，且胰岛素需求量相似（美敦力780G系统：TIR 73.9±11.2%，TBR 0.9±1.2%，CV 29±6.7%；带有Control-IQ系统的丹德姆t:slim X2：TIR 74.1±11.1%，TBR 1.1±1.0%，CV 34.5±6.6%；DBLG1系统：TIR 71.7±11.3%，TBR 1.4±3.7%，CV 32.4±7.1%）。与美敦力780G组（42.1±13.7%）和DBLG1系统组（40.1±10.5%）相比，带有Control-IQ系统的丹德姆t:slim X2组的严格TIR%（70 - 140mg/dl）显著更高（p<0.01）（51.5±9.8%）。在所有三组中，胰岛素输注量从午夜到凌晨5点同样减少，然后增加。
所有三种AHCL系统均达到了推荐的TIR、TBR和CV，且胰岛素需求量无差异。丹德姆Control-IQ系统获得了更高的严格TIR。
