Amir Tirosh, IsraelCh. Sheba Medical Center Institute of Endocrinology
Presenter Of 1 Presentation
UNANNOUNCED MEAL CHALLENGES IN A PROTECTED FREE LIVING ENVIRONMENT USING THE MINIMED 670G 4.0 SYSTEM
Background and Aims
Advanced closed loop (ACL) algorithms combine automated basal rate with additional enhancement when correction is required, usually post meal. Preliminary studies have demonstrated increased time spent in target glucose range of 70-180 mg/dL (TIR) with reduction in post prandial excursion. Here, we assessi the effectiveness of the algorithm to overcome no premeal bolus.
Four participants were followed for 4 days in a protected free living environment, while consuming pre-defined meals consisting of either 40, 60 and 80 grams of carbohydrates each day. Participants consumed the same meals and either bolus or did not bolus before consuming the meals according to the following protocol: Day1, all meals announced. Day 2 , participants announce only the 80 gr carb meal. In days 3 and 4, all meals unannounced
Preliminary results of 4 adult participants show that overall glycemia during the unannounced meal phase demonstrated a 73.2% (±9.6) TIR of 70-180 mg% and 0% time in hypoglycemia <70mg%. Reduction in total daily dose and requirements for glucose salvage was noted. Comparison between the post meal excursion of the announced versus unannounced meals demonstrated a separation of excursion, when the carbs was above 40 grams. The peak glucose levels of unannounced meals did not differ between the 40, 60 and 80 gram carbohydrate-containing meals,
MINIMEDTM 670G 4.0 system is programmed for meal announcement. Nevertheless, when meals containing < 80 gram of carbohydrates are consumed without meal announcement, the system is able to provide safe glycemic control with over 70% of TIR.