Sheba Medical Center
Division of Endocrinology, Diabetes and Metabolism
Maya is the head dietitian and the head of the technology research unit at the division of endocrinology, Diabetes and Metabolism at Sheba Medical Center in Israel. Maya is currently completing her master's degree in public health "Complex meal handling by AHCL systems for T1D adults". She is a chair at the National Nutrition and Dietetics Association.
Presenter of 2 Presentations
Announcing meals from across the world in a simplified manner with the MiniMed™ 780G system (ID 1153)
Presenter
Lecture Time
13:15 - 14:00
Session Type
INDUSTRY
Date
Thu, 23.02.2023
Session Time
13:00 - 14:30
Room
Hall A5
IS056 - Complex meal handling with advanced hybrid closed-loop system (ID 266)
Presenter
Lecture Time
09:50 - 10:10
Session Type
PARALLEL SESSION
Date
Sat, 25.02.2023
Session Time
09:30 - 11:00
Room
Hall A1
Session Icon
Abstract
Abstract Body
Background: Meal management is a major challenge for people with type 1 diabetes (PWD), especially of complex meals, containing high amount of protein and fat. More recently, advanced hybrid closed loop systems are available for diabetes management which reduce the daily burden of diabetes management. Yet, it is unclear how these systems respond to complex meals, and patient guidance for managing complex meals using these advanced technologies is lacking.Objective: To explore 3 approaches of high-fat, high-protein (HFHP) meal management for people with diabetes (PWD) from most comprehensive scheme using the current standard of care (an open loop [OL] system), to a simplified, carbohydrate (CHO) counting-free approach using an advanced hybrid closed loop (AHCL) system.
Research Design and methods: An open label trail, among 15 adults with T1DM using AHCL system. The outcomes compared were postprandial glycemic control after consuming a controlled pizza meal across 3 study conditions: 1) Standard of care bolus using OL therapy with sensor augmented pump therapy with predictive low glucose management feature on. 2) Meal bolus using AHCL system with accurate CHO counting (CL). 3) Meal bolus using AHCL system with CHO-free predefine bolus (CLP)
Results: Thirteen Participants, mean age 46.8±12.8 years and baseline hemoglobin A1C (HbA1c) of 6.1±1.2% completed the study. No differences were observed in time spent in target range (TIR) of glucose 70–180 mg/dL (3.9–10 mmol/L) between the groups during 5.0-hr post meal, but a significant higher TIR overnight was observed using either CL or CLP compared to OL (86.8±13.4 and 81.8±20.1 vs. 68.4±22.6 , p<0.0001 and p=0.023, respectively). During a 12.0-hr post meal period, OL mean sensor glucose (MSG) and TIR were significantly inferior in comparison to CL and to CLP with a tendency for higher rates of hypoglycemia
Conclusions: Our results indicate that glycemic control following a HFHP meal challenge by automated insulin system with or without accurate CHO counting is superior when compared with the highly burdensome meal management using OL and with less tendency for hypoglycemia. Thus, complex meal management using AHCL systems may improve glycemic outcomes and alleviate disease burden for PWD.