P-142: The calm-T1D study: bridging the mind-glucose gap with automated insulin delivery during exam-related stress among high school students
N Elbarbany, N Nagy, L Ahmed Ismail, S Ashraf Abouelnasr, E Abdel Rahman IsmailAbstract
Introduction
Academic stress can significantly impact glycemic outcome and psychological well-being in adolescents with type 1diabetes (T1D).
Objectives
To evaluate the role of MiniMed™ 780G insulin pump in managing exam-induced glycemic deterioration among high school students with T1D.
Methods
This prospective study included 56 adolescents with T1D using MiniMed™ 780G insulin pump. Participants were monitored during routine academic and exam periods. Psychological stress was measured using the Perceived Stress Scale (PSS-10), Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D). Serum cortisol level was assessed and continuous glucose monitoring (CGM) data were monitored. Paired t-test and Wilcoxon test were used for parametric and non-parametric data, respectively to identify changes in study variables between study periods. A p value < 0.05 was considered statistically significant.
Results
Although PSS-10, HAM-A and HAM-D scores as well as serum cortisol level (15.7 ± 4.6 versus 8.6 ± 3.1 μg/dL) were elevated in high school students with T1D during exam period compared with baseline values (p<0.001); however, no significant change was found as regards mean sensor glucose (153.23 ± 14.1 versus 147.51 ± 13.7 mg/dL; p=0.561), coefficient of variation (35.11 ± 8.0 versus 32.81 ± 8.2%; p=0.167), time in range (TIR) (75.10 ± 8.8 versus 78.20 ± 9.0%; p=0.086) and time in tight range (58.50 ± 7.0 versus 60.10 ± 7.5%; p=0.311) which corresponds with the significant increase in auto basal and auto correction insulin delivery of MiniMed™ 780G (p<0.001).
Conclusions
The automated adaptive algorithm of the MiniMed™ 780G system mitigated exams-related stress hyperglycemia, reducing glycemic variability and successfully maintaining the recommended glycemic outcomes with a TIR greater than 70% throughout the exam period.