Michael A Wood1, Dorothy I Shulman2, Gregory P Forlenza3, Bruce W Bode4, Orit Pinhas-Hamiel5, Bruce A Buckingham6, Kevin B Kaiserman7, David R Liljenquist8, Timothy S Bailey9, John Shin10, Suiying Huang10, Xiaoxiao Chen10, Toni L Cordero10, Scott W Lee10, Francine R Kaufman10. 1. 1 Division of Pediatric Endocrinology, University of Michigan Medical School , Ann Arbor, Michigan. 2. 2 USF Diabetes Center, Morsani College of Medicine, University of South Florida , Tampa, Florida. 3. 3 Barbara Davis Center for Childhood Diabetes , Aurora, Colorado. 4. 4 Atlanta Diabetes Associates , Atlanta, Georgia . 5. 5 Edmond and Lily Safra Children's Hospital, Sheba Medical Center , Tel Aviv, Israel . 6. 6 Department of Pediatric Endocrinology, Stanford University , Stanford, California. 7. 7 SoCal Diabetes , Torrance, California. 8. 8 Rocky Mountain Diabetes and Osteoporosis Center , Idaho Falls, Idaho. 9. 9 AMCR Institute , Escondido, California. 10. 10 Medtronic , Northridge, California.
Abstract
BACKGROUND: The Medtronic predictive low-glucose management (PLGM) algorithm automatically stops insulin delivery when sensor glucose (SG) is predicted to reach or fall below a preset low-glucose value within the next 30 min, and resumes delivery after hypoglycemia recovery. The present study evaluated the PLGM algorithm performance of the MiniMed™ 670G system SmartGuard™ "suspend before low" feature in children aged 7-13 years with type 1 diabetes (T1D). METHOD: Participants (N = 105, mean ± standard deviation of 10.8 ± 1.8 years) underwent an overnight in-clinic evaluation of the "suspend before low" feature with a preset low limit of 65 mg/dL. After exercise, frequent sample testing (FST) was conducted every 5 min if values were <70 mg/dL; every 15 min if 70-80 mg/dL; and every 30 min if >80 mg/dL. First-day performance of the Guardian™ Sensor 3 glucose sensor and continuous glucose monitoring system was also evaluated. RESULTS: Activation of the "suspend before low" feature occurred in 79 of the 105 participants, 79.7% (63/79) did not result in SG falling below 65 mg/dL. Mean glucose at activation was 102 ± 19 mg/dL and the initial insulin suspension duration was 87.5 ± 32.7 min. Four hours after insulin resumption, mean reference glucose was 130 ± 42 mg/dL. Mean absolute relative difference between the FST reference glucose and SG values on the first day of sensor wear was 11.4%. For the 26 participants in whom the "suspend before low" feature did not activate, none involved a reference glucose value ≤65 mg/dL, suggesting that the PLGM algorithm performed as intended. CONCLUSION: In children aged 7-13 years with T1D, the "suspend before low" feature of the MiniMed 670G system demonstrated a hypoglycemia prevention rate of nearly 80% after exercise and did not involve rebound hyperglycemia. There were no events of severe hypoglycemia during the evaluation.
BACKGROUND: The Medtronic predictive low-glucose management (PLGM) algorithm automatically stops insulin delivery when sensor glucose (SG) is predicted to reach or fall below a preset low-glucose value within the next 30 min, and resumes delivery after hypoglycemia recovery. The present study evaluated the PLGM algorithm performance of the MiniMed™ 670G system SmartGuard™ "suspend before low" feature in children aged 7-13 years with type 1 diabetes (T1D). METHOD:Participants (N = 105, mean ± standard deviation of 10.8 ± 1.8 years) underwent an overnight in-clinic evaluation of the "suspend before low" feature with a preset low limit of 65 mg/dL. After exercise, frequent sample testing (FST) was conducted every 5 min if values were <70 mg/dL; every 15 min if 70-80 mg/dL; and every 30 min if >80 mg/dL. First-day performance of the Guardian™ Sensor 3 glucose sensor and continuous glucose monitoring system was also evaluated. RESULTS: Activation of the "suspend before low" feature occurred in 79 of the 105 participants, 79.7% (63/79) did not result in SG falling below 65 mg/dL. Mean glucose at activation was 102 ± 19 mg/dL and the initial insulin suspension duration was 87.5 ± 32.7 min. Four hours after insulin resumption, mean reference glucose was 130 ± 42 mg/dL. Mean absolute relative difference between the FST reference glucose and SG values on the first day of sensor wear was 11.4%. For the 26 participants in whom the "suspend before low" feature did not activate, none involved a reference glucose value ≤65 mg/dL, suggesting that the PLGM algorithm performed as intended. CONCLUSION: In children aged 7-13 years with T1D, the "suspend before low" feature of the MiniMed 670G system demonstrated a hypoglycemia prevention rate of nearly 80% after exercise and did not involve rebound hyperglycemia. There were no events of severe hypoglycemia during the evaluation.
Authors: Cari Berget; Jennifer L Sherr; Daniel J DeSalvo; Ryan S Kingman; Sheri L Stone; Sue A Brown; Alex Nguyen; Leslie Barrett; Trang T Ly; Gregory P Forlenza Journal: Clin Diabetes Date: 2022-04-15
Authors: Gregory P Forlenza; Orit Pinhas-Hamiel; David R Liljenquist; Dorothy I Shulman; Timothy S Bailey; Bruce W Bode; Michael A Wood; Bruce A Buckingham; Kevin B Kaiserman; John Shin; Suiying Huang; Scott W Lee; Francine R Kaufman Journal: Diabetes Technol Ther Date: 2018-12-26 Impact factor: 6.118
Authors: Rayhan A Lal; Marina Basina; David M Maahs; Korey Hood; Bruce Buckingham; Darrell M Wilson Journal: Diabetes Care Date: 2019-09-23 Impact factor: 19.112