Insulin Requirements for Basal and Auto-Correction Insulin Delivery in Advanced Hybrid Closed-Loop System: 4193 Days’ Real-World Data of Children in Two Different Age Groups
Authors' conclusion
The basal insulin need follows a diurnal pattern with two significantly different periods-high between 00.00 and 10.00 and low between 10.00 and 00.00. The auto-correction rates are low between 05.00 and 10.00 and show an increasing pattern peaking between 21.00 and 00.00. These findings are compatible with the dawn and reverse dawn phenomena.
Study context
- Population
- Children with T1D using MiniMed 780G advanced hybrid closed-loop system; pump and continuous glucose monitoring (CGM) data from Medtronic CareLink; mean age 12.3 years, mean diabetes duration 6.1 years4,193 days' data
- Participants
- 34 children
- Exposure
- Children <9 years vs >9 years; time-of-day periods
- Outcome
- Hourly variation in micro bolus (basal) and auto-correction bolus insulin requirements
Methodological detailshourly analysis of micro and auto-correction boluses, two age groups
- Hourly analysis of micro and auto-correction boluses
- Two age groups
Main finding
As reported in the abstract
- Micro bolus (basal) ratio higher 05.00–07.00 than 10.00–03.00
- P < .01
- Micro bolus lower 19.00–21.00 than 00.00–10.00
- P < .001
- Auto-correction ratio higher 21.00–00.00 than 03.00-17.00
- P < .001
- Auto-correction ratio higher 21.00–00.00 than 19.00-21.00
- P = .008
- Auto-correction lower 07.00–10.00 than 10.00–03.00
- P < .001
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Micro bolus ratio by age groupBelow nine years vs Above nine years · higher in below nine years, 21.00-00.00 | P = 0.026 |
| Micro bolus ratio by age groupBelow nine years vs Above nine years · higher in below nine years, 00.00-03.00 | P = 0.003 |
Glycaemic metrics
- Mean time in range (TIR)
- 80.5%
- Mean glucose management indicator (GMI)
- 6.6%
Original publication
Insulin Requirements for Basal and Auto-Correction Insulin Delivery in Advanced Hybrid Closed-Loop System: 4193 Days’ Real-World Data of Children in Two Different Age Groups. J Diabetes Sci Technol. Published 30 June 2022. doi:10.
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