Announced Meals at will with the MiniMed™ Advanced Hybrid Closed Loop (AHCL) Reduce Diabetes-Related Distress

Introduction:

Little is known about selective meal announcement using the MinMed™ AHCL system, designed for optimal performance with announcement of all meals.

Aims:

To compare glycemic outcomes and patient experience during MiniMed™ 780G AHCL system use while announcing all meals versus announcing meals at will.

Methods:

Participants used the MiniMed™ AHCL system at home during two 90 days phases in which they were given instructions to announce all meals (AM), and next to announce meals at will (AMW), for meals containing up to 80 grams of carbohydrates.

Results:

Fourteen subjects (10 males, mean age 44.3±11) with T1DM were enrolled, with a baseline A1C of 6.9±1%. Table 1 summarizes glycemic indices and AHCL data, demonstrating that patients chose to bolus only slightly less during AMW compared to AM (5.5 vs. 5.2 boluses), without resultant deterioration in glycemic indices (A1c 6.4 vs. 6.5%, TIR 78.1 vs. 78.8%, p=ns). Subjects surveyed regarding the option not to have to bolus for all meals experienced a significant reduction in reported effort to manage diabetes (p=0.045) and 86% endorsed worrying less about their diabetes. Most (93%) preferred the AMW phase of the study.

Conclusions:

Though the MiniMed™ AHCL system is designed for optimal performance with meal announcement, when meals containing < 80 grams of carbohydrates are consumed with announcement of meals at will, there is a slight reduction in the number of daily boluses with no decline in glycemic control, yet markedly less diabetes related distress and improved treatment satisfaction.