P-499: The use of an advanced hybrid closed-loop automated insulin delivery system in under 7-year-old children: evidence from real-world data
I Kyrgios, A Tzagkaraki, E Kollia, A Triantafyllidou, A Vazeou-Gerasimidi, M XatzipsaltiAbstract
Introduction
Recent technological advances such as continuous glucose monitoring (CGM), continuous subcutaneous insulin infusion (CSII) and automated insulin delivery (AID) systems have resulted in more demanding glycaemic targets, if available. Achieving the optimal glycaemic control can be quite challenging especially in younger children living with type 1 diabetes (T1D).
Objectives
To evaluate the efficacy and safety of the Medtronic MiniMed 780G advanced hybrid closed-loop automated insulin delivery system (SmartGuard) in T1D children under 7 years of age.
Methods
Data from 36 children that started on the MiniMed 780G AID system before the age of 7 years old were retrospectively analysed. 14-day reports were obtained from CareLink on the following time points: prior to SmartGuard initiation, and then at 3, 6, 9, and 12 months on treatment. Metabolic parameters were also collected. Data were statistically analysed with one-way repeated measures ANOVA.
Results
Over the 1-year period of follow-up, a significant increase in time in range (TIR) and time in tight range (TITR) (p<0.001), as well as a significant decrease in mean glucose levels (p<0.001), glucose management indicator (GMI) (p=0.002), and time above range (TAR) (p =0.002) were found. No significant changes were observed in the time below range (TBR) (p=0.0782) or variation coefficient (CV) (p=0.270). No events of severe hypoglycemia or diabetic ketoacidosis occurred throughout the observation period.
Conclusions
The use of the MiniMed 780G™ SmartGuard™ system in very young children with T1D is considered effective and safe, and their beneficial effect is maintained for at least 12 months of use. More studies with larger numbers of patients and longer periods of observations are required to validate these findings.