The impact of an advanced closed-loop hybrid system on glucoregulation in children and adolescents with type 1 diabetes - experience of a single center
DOI:
https://doi.org/10.13112/pc.1160Keywords:
Adolescent; Child; Diabetes Mellitus, Type 1; Continuous Glucose MonitoringAbstract
Objective: Advanced hybrid closed-loop systems for automated insulin delivery facilitate achievement of therapeutic goals in people with diabetes. The aim of this study was to evaluate the effectiveness of the aforementioned system in the optimization of type 1 diabetes management in children and adolescents.
Methods: A retrospective study conducted at the Department of Pediatrics, Clinical Hospital Center Sestre milosrdnice, included children and adolescents with type 1 diabetes, users of continuous glucose monitoring systems, who had been using an advanced hybrid closed-loop system (Medtronic MiniMed 780G) for at least 3 months, from March 2021 to May 2025. Demographic data, information on insulin therapy, and quality of glycemic control were collected from medical records and cloud-based software platforms. For comparison of glycemic control parameters (time in, above and below range, glycated hemoglobin), 28-day periods before and after the introduction of the advanced hybrid closed-loop system were employed.
Results: Of 35 subjects (mean age 15.0±3.3 years, 23 male), before the introduction of the advanced hybrid closed-loop system, 20 were on multiple daily insulin injections, and 15 had insulin pumps without real-time automatic adjustment of insulin delivery. Introduction of advanced hybrid closed loop system with automated insulin delivery resulted in more time spent in range (55.2 % vs. 73.1 %, p<0.001), less time spent above (41.3 vs. 24.8 %, p<0.001) and below the range (3.5 vs. 2.1 %, p=0.002), and a decrease in glycated hemoglobin (7.7 % vs. 7.1 %, p<0.001).
Conclusion: Advanced hybrid closed-loop systems provide clinically significant improvements in glycaemic control in children and adolescents with type 1 diabetes mellitus.
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