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Publications

Journal Article Epublish 1 citation

PubMed: 37959415 DOI: 10.3390/jcm12216951

Pediatric Type 1 Diabetes: Is Age at Onset a Determining Factor in Advanced Hybrid Closed-Loop Insulin Therapy?

J Clin Med 12(21)

Authors: Alfonso Lendínez-Jurado, Juan Pedro López-Siguero, Ana Gómez-Perea, Ana B Ariza-Jiménez, Icía Becerra-Paz, Leopoldo Tapia-Ceballos, Carmen Cruces-Ponce, José Manuel Jiménez-Hinojosa, Sonsoles Morcillo, Isabel Leiva-Gea

Affiliations

  • Department of Pediatric Endocrinology, Hospital Regional Universitario de Málaga, 29011 Málaga, Spain.
  • Departamento de Farmacología y Pediatría, Universidad de Málaga, Andalucía Tech, Campus de Teatinos s/n, 29071 Málaga, Spain.
  • Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain.
  • Department of Pediatric Endocrinology, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain.
  • Department of Pediatrics, University of Cordoba, Av. Menéndez Pidal, 7, 14004 Córdoba, Spain.
  • Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain.
  • Department of Pediatric Endocrinology, Hospital Regional Universitario de Málaga, 29011 Málaga, Spain. Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain.
  • Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain.
  • CIBER in Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III Madrid, 29010 Málaga, Spain.

Abstract

BACKGROUND

The integration of continuous glucose monitoring systems with insulin infusion pumps has shown improved glycemic control, with improvements in hyperglycemia, hypoglycemia, Hb1Ac, and greater autonomy in daily life. These have been most studied in adults and there are currently not many articles published in the pediatric population that establish their correlation with age of debut.

METHODS

Prospective, single-study. A total of 28 patients (mean age 12 ± 2.43 years, 57% male, duration of diabetes 7.84 ± 2.46 years) were included and divided into two groups according to age at T1D onset (≤4 years and >4 years). Follow-up for 3 months, with glucometric variables extracted at different cut-off points after the start of the closed-loop (baseline, 1 month, 3 months).

RESULTS

Significant improvement was evidenced at 1 month and 3 months after closed-loop system implantation, with better glycemic control in the older age group at baseline at TIR (74.06% ± 6.37% vs. 80.33% ± 7.49% at 1 month, < 0.003; 71.87% ± 6.58% vs. 78.75% ± 5.94% at 3 months, < 0.009), TAR1 (18.25% ± 4.54% vs. 14.33% ± 5.74% at 1 month, < 0.006; 19.87% ± 5.15% vs. 14.67% ± 4. 36% at 3 months, < 0.009) and TAR2 (4.75% ± 2.67% vs. 2.75% ± 1.96% at 1 month, = 0.0307; 5.40% ± 2.85% vs. 3% ± 2.45% at 3 months, < 0.027).

CONCLUSIONS

the use of automated systems such as the MiniMed780G system brings glucometric results closer to those recommended by consensus, especially in age at T1D onset >4 years. However, the management in pediatrics continues to be a challenge even after the implementation of these systems, especially in terms of hyperglycemia and glycemic variability.

MeSH

Diabetes Mellitus, Insulin, Hyperglycemia, Therapeutics, Diabetes Mellitus, Type 1, Glycemic Control, Age Of Onset

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