Impact of Missed and Late Meal Boluses on Glycemic Outcomes in Automated Insulin Delivery-Treated Children and Adolescents with Type 1 Diabetes: A Two-Center, Population-Based Cohort Study
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Research Design and Methods: AID-treated (Tandem Control-IQ or Medtronic MiniMed 780G) children and adolescents (aged 6–21 years) from Stanford Medical Center and Steno Diabetes Center Copenhagen with ≥10 days of data were included in this two-center, binational, population-based, retrospective, 1-month cohort study. The primary outcome was the association between the number of algorithm-detected MLBs and time in target glucose range (TIR; 70–180 mg/dL).
Results: The study included 189 children and adolescents (48% females with a mean ± standard deviation age of 13 ± 4 years). Overall, the mean number of MLBs per day in the cohort was 2.2 ± 0.9. For each additional MLB per day, TIR decreased by 9.7% points (95% confidence interval [CI] 11.3; 8.1), and compared with the quartile with fewest MLBs (Q1), the quartile with most (Q4) had 22.9% less TIR (95% CI: 27.2; 18.6). The age-, sex-, and treatment modality-adjusted probability of achieving a TIR of >70% in Q4 was 1.4% compared with 74.8% in Q1 (P < 0.001).
Conclusions: MLBs significantly impacted glycemic outcomes in AID-treated children and adolescents. The results emphasize the importance of maintaining a focus on bolus behavior to achieve a higher TIR and support the need for further research in technological or behavioral support tools to handle MLBs.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Diabetes Technology and Therapeutics |
| Antal sider | 11 |
| ISSN | 1520-9156 |
| DOI | |
| Status | Accepteret/In press - 2024 |
Bibliografisk note
Funding Information:
C.L. was employed by Steno Diabetes Center Copenhagen during the conduct of the study but as of November 1, 2022, is employed by, and owns shares in, Novo Nordisk. B.B. has been on the advisory boards for Medtronic, Lilly, and Novo Nordisk and has received research support from Insulet, Medtronic Diabetes, and Tandem. J.S. owns shares in Novo Nordisk and has received teacher and speaker honorarium from Medtronic, Novo Nordisk, Rubin Medical, and Sanofi Aventis. K.N. owns shares in Novo Nordisk, has been a paid consultant for Novo Nordisk and Medtronic, and has received speaker and advisory board honorarium for her institution from Medtronic, Novo Nordisk, Insulet, and Convatec, and her institution has received research funding from Zealand Pharma, Novo Nordisk, Medtronic, and Dexcom. L.E. receives salary support from National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); has served on the advisory board of Diabetes Center Berne, Sequel, and Metronic; has received research support from Juvenile Diabetes Research Foundation (JDFR), Medtronic, Abbot and Mankind; has received consulting fees from Jaeb, Tandem Diabetes Care and Ypsomed; and has served as a speaker for Insulet. No other potential conflicts of interest relevant to this article were reported.
Funding Information:
This research was supported financially by grants from the William Demant Foundation (21-2636), the Danish Diabetes Association, Julie Von M\u00FCllen\u2019s Foundation, and A.V. Lykfeldt and Wife.
Publisher Copyright:
Copyright 2024, Mary Ann Liebert, Inc., publishers.
ID: 397800357