Unannounced Meal Challenges Using an Advanced Hybrid Closed-Loop System
Authors' conclusion
The AHCL system is optimized for use with meal announcement. While not announcing meals of ≤80 g carbohydrates appears to be safe, it results in suboptimal postprandial glycemic control, especially with high-carbohydrate meals. Not announcing small meals (≤20 g carbohydrate) does not deteriorate glycemic control.
Study context
- Population
- Adults with T1D using the MiniMed 780G advanced hybrid closed-loop (AHCL) system
- Participants
- 14 adults
- Comparison
- MiniMed 780G AHCL with unannounced vs announced meals
- Outcome
- TIR 70-180 mg/dL
Methodological detailssupervised 5-day phase followed by two 90-day at-home phases (unannounced then announced meals)
- Supervised 5-day phase followed by two 90-day at-home phases (unannounced then announced meals)
Main finding
As reported in the abstract
P < 0.01
Further findings
| Outcome | Unannounced | Announced |
|---|---|---|
| Time 180-250 mg/dL | 22.7% ± 7.7% | 15.7% ± 7.2% |
| Time >250 mg/dL | 7.9% ± 6.4% | 3.6% ± 2.7% |
Meal-size thresholds
- Unannounced meals up to 60 g carbohydrate did not increase postprandial extreme dysglycemia >250 mg/dL
- Up to 20 g unannounced carbohydrates did not significantly change TIR 70-180 mg/dL vs full announcement
Safety
| Outcome | Unannounced | Announced |
|---|---|---|
| Time 54-70 mg/dL | 1.6% ± 1% | 2.8% ± 1.8% |
| Time <54 mg/dL | 0.3% ± 0.4% | 0.7% ± 0.9% |
Original publication
Unannounced Meal Challenges Using an Advanced Hybrid Closed-Loop System. Diabetes Technol Ther. Published 23 August 2023. doi:10.
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