美敦力780G推荐设置（血糖目标100mg/dL，活性胰岛素作用时间2小时）在1型糖尿病青少年及青年中的真实世界疗效。
Real-world efficacy of MiniMed™780G recommended settings (glycemic target 100 mg/dL, active insulin time 2 hours) in youth and young adults with type 1 diabetes.
作者信息
Bassi Marta, Spacco Giordano, Pezzotta Federico, Di Jorgi Margherita, Siri Giulia, Pintabona Andrea, Calevo Maria Grazia, Minuto Nicola, Maghnie Mohamad
机构信息
DINOGMI - Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.
Pediatric Clinic, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
出版信息
Front Endocrinol (Lausanne). 2025 Sep 12;16:1670266. doi: 10.3389/fendo.2025.1670266. eCollection 2025.
BACKGROUND AND AIMS
Despite growing evidence supporting the efficacy and safety of the MiniMed™ 780G recommended settings (Glucose Target 100 mg/dL and Active Insulin Time 2 hours), their adoption in routine practice remains limited, mainly due to concerns about hypoglycemia. This study aimed to evaluate the impact of switching to these settings in pediatric and young patients with type 1 diabetes (T1D).
METHODS
We conducted a retrospective longitudinal analysis in children and young adults using MiniMed™780G system at our center. Patients who switched from their initial settings to a glucose target of 100 mg/dL and an active insulin time of 2 hours for clinical indications were included. Data were retrospectively collected 3 months after switch. Glycemic metrics were compared over the 14 days before the switch (T0) and at 1 month (T1), and 3 months (T3).
RESULTS
Ninety-one patients with a mean age of 17.89y were included, 81.3% of whom already had a glucose target of 100 mg/dL at baseline. Therefore, in most cases the primary change was reducing AIT from 3 to 2 hours. After switching to the recommended settings, Time in Range (TIR) significantly increased (p<0.001) at T1 (71.9% 74.8%) and T3 (71.9% 75.0%). Time in target range (TITR) similarly improved from 47.2% at T0 to 51.4% at T1 and 50.9% at T3 (p<0.001) without any significant increase in time below range (TBR). The proportion of patients meeting all ADA-recommended glycemic targets rose from 29.5% at baseline to 40% at T3. Following the switch, the contribution of automatic correction boluses to the total insulin dose increased, while overall daily insulin requirements remained stable.
CONCLUSIONS
Switching to the recommended MiniMed™780G settings, driven primarily by AIT reduction in most patients, was safe and effective, improving glycemic control without increasing hypoglycemia. These findings support broader use of these settings in pediatric and young adult patient with type 1 diabetes.
背景与目的
尽管越来越多的证据支持美敦力780G系统推荐设置（血糖目标值100mg/dL和活性胰岛素时间2小时）的有效性和安全性，但在常规临床实践中的采用率仍然有限，主要是因为担心低血糖。本研究旨在评估在1型糖尿病（T1D）儿童和年轻患者中切换至这些设置的影响。
方法
我们对在本中心使用美敦力780G系统的儿童和年轻成人进行了一项回顾性纵向分析。纳入因临床指征从初始设置切换至血糖目标值100mg/dL和活性胰岛素时间2小时的患者。在切换3个月后回顾性收集数据。比较切换前14天（T0）、1个月（T1）和3个月（T3）时的血糖指标。
结果
纳入91例平均年龄为17.89岁的患者，其中81.3%在基线时血糖目标值已为100mg/dL。因此，在大多数情况下，主要变化是将活性胰岛素时间从3小时减少至2小时。切换至推荐设置后，在T1（71.9%对74.8%）和T3（71.9%对75.0%）时，血糖达标时间（TIR）显著增加（p<0.001）。目标范围内时间（TITR）同样从T0时的47.2%改善至T1时的51.4%和T3时的50.9%（p<0.001），且低于目标范围时间（TBR）无显著增加。达到美国糖尿病协会（ADA）所有推荐血糖目标的患者比例从基线时的29.5%升至T3时的40%。切换后，自动校正大剂量胰岛素占总胰岛素剂量的比例增加，而每日胰岛素总需求量保持稳定。
结论
在大多数患者中，主要通过减少活性胰岛素时间驱动，切换至美敦力780G系统的推荐设置是安全有效的，在不增加低血糖的情况下改善了血糖控制。这些发现支持在1型糖尿病儿童和年轻成人患者中更广泛地使用这些设置。
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