Adolescents with type 1 diabetes vs. hybrid closed loop systems: a case series of patients’ behaviour that challenges the algorithm.
Author:
Zanfardino Angela1ORCID, Piscopo Alessia1, Gizzone Pietro1, Vitulano Caterina1, Di Gennaro Federica1, Buccella Giulia1, Fabozzi Irma1, Mainolfi Gabriella1, Marongiu Mariagrazia Bathilde1, Rollato Assunta S.1, Testa Veronica1, Chianese Antonietta1, Miraglia del Giudice Emanuele1, Troncone Alda2, Iafusco Dario1
Affiliation:
1. Department of Pediatrics, Regional Center for Pediatric Diabetes , University of the Study of Campania , Naples , Italy 2. Department of Psychology , University of Campania “Luigi Vanvitelli” , Caserta , Italy
Abstract
Abstract
Objectives
Hybrid closed loop systems (HCL) improve the management of type 1 diabetes (T1DM). T1DM adolescent patients represent a risk category also if they are in an automated insulin infusion delivery therapy.
Case presentation
We describe a series of four cases in which adolescent patients have adopted incorrect behaviours in the managing of HCL systems, challenging the algorithm skills. Two patients performed fabricated sensor calibrations. The other two did not perform pre-prandial insulin boluses correctly. Despite these behaviours, the algorithm corrected the glucose values in three out of four patients. Only in one case, where fabricated calibrations were too frequent, the automatic system failed to restore the glycemic balance.
Conclusions
Fabricated calibrations seem to be more important than uncorrected insulin boluses to challenge the HCL systems.
Publisher
Walter de Gruyter GmbH
Subject
Endocrinology,Endocrinology, Diabetes and Metabolism,Pediatrics, Perinatology and Child Health
Reference10 articles.
1. Sherr, JL, Tauschmann, M, Battelino, T, de Bock, M, Forlenza, G, Roman, R, et al.. ISPAD clinical practice consensus guidelines 2018: diabetes technologies. Pediatr Diabetes 2018;19:302–25. https://doi.org/10.1111/pedi.12731. 2. Sharifi, A, De Bock, MI, Jayawardene, D, Loh, MM, Horsburgh, JC, Berthold, CL, et al.. Glycemia, treatment satisfaction, cognition, and sleep quality in adults and adolescents with type 1 diabetes when using a closed-loop system overnight versus sensor-augmented pump with low-glucose suspend function: a randomized crossover study. Diabetes Technol Therapeut 2016;18:772–83. https://doi.org/10.1089/dia.2016.0288. 3. Abraham, MB, de Bock, M, Smith, GJ, Dart, J, Fairchild, JM, King, BR, et al.. Effect of a hybrid closed-loop system on glycemic and psychosocial outcomes in children and adolescents with type 1 diabetes: a randomized clinical trial. JAMA Pediatr 2021;175:1227–35. https://doi.org/10.1001/jamapediatrics.2021.3965. 4. Collyns, OJ, Meier, RA, Betts, ZL, Chan, DSH, Frampton, C, Frewen, CM, et al.. Improved glycemic outcomes with medtronic MiniMed advanced hybrid closed-loop delivery: results from a randomized crossover trial comparing automated insulin delivery with predictive low glucose suspend in people with type 1 diabetes. Diabetes Care 2021;44:969–75. https://doi.org/10.2337/dc20-2250. 5. Seget, S, Rusak, E, Polańska, J, Jarosz-Chobot, P. Prospective open-label single-arm, single-center follow-up study of the application of the Advanced Hybrid Closed Loop system in well-controlled children and adolescents with type 1 diabetes. Diabetes Technol Therapeut 2022;24:824–31. https://doi.org/10.1089/dia.2022.0148.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|