Mitigation Strategies for a Missed Meal Bolus in People with Type 1 Diabetes Using the Minimed ™ 780G System
Authors' conclusion
Premeal bolusing yields optimal postprandial glycemic control with the MM780G. However, when a meal bolus is missed, administering a corrective bolus of 50% carbohydrate content 1 h postmeal significantly improves TIR and TITR without increasing hypoglycemia risk. If correction is not performed, the MM780G system can provide a reasonable partial compensation via autobasal and auto-correction.
Study context
- Population
- Adults with T1D using the MiniMed 780G AHCL system; standardized meals (∼60 g carbohydrates)all completed all strategies
- Participants
- 32 adults
- Exposure
- Premeal bolus vs no bolus vs delayed 50% bolus 60 min postmeal
- Outcome
- Postprandial time in range (TIR) (70-180 mg/dL)
- Follow-up
- 4-h postprandial
Methodological detailsopen-label, real-world, remote supervision, Each participant completed all strategies under remote supervision
- Open-label
- Real-world
- Remote supervision
- Each participant completed all strategies under remote supervision
Main finding
As reported in the abstract
E1 vs E2: P < 0.001 · E1 vs E3: P < 0.001 · E3 vs E2: P < 0.001
Observational data: associations, not effects.
Secondary outcomes
Time in tight range (TITR) (70-140 mg/dL)
- TITR followed a similar pattern
Time >250 mg/dL
- E3 lowered time above 250 mg/dL vs E2
Safety
Hypoglycaemia, severe hypoglycaemia and ketoacidosis · 4 h postprandial
- Time 54–70 mg/dL slightly higher for E1 but within consensus goals
- No significant differences in hypoglycaemia (<54 mg/dL) across strategies
- No severe hypoglycaemia or ketoacidosis occurred
Original publication
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