Can the AHCL System Be Used in T1D Patients with Borderline TDDI? A Case Report

Sensors (Basel). 2021 Oct 29;21(21):7195. doi: 10.3390/s21217195.

Abstract

(1) Background: Intensive insulin therapy using continuous subcutaneous insulin infusion (CSII) with continuous real-time glucose monitoring (rt CGM) is the best option for patients with T1D. The recent introduction of a technology called Advanced Hybrid Closed Loop (AHCL) represents a new era in the treatment of type 1 diabetes, the next step towards better care, as well as improving the effectiveness and safety of therapy. The aim is to present the case of a T1D patient with a borderline total daily dose of insulin being treated with the Medtronic AHCL system in automatic mode. (2) Materials and Methods: A 9-year-old boy, from October 2020, with type 1 diabetes in remission was connected to the Minimed™ 780G (AHCL) system in accordance with the manufacturer's recommendations (daily insulin dose > 8 units, age > 7). Records of the patient's history were collected from visits to The Department of Children's Diabetology, as well as from the Medtronic CareLink™ software and the DPV SWEET program from October 2020 to April 2021. (3) Results: The patient's total daily insulin requirement decreased in the first 6 weeks after the AHCL was connected, which may reflect the remission phase (tight glycemic control with a healthy lifestyle). The lowest daily insulin requirement of 5.7 units was also recorded. In a three-month follow-up of the patient treated with AHCL, it was found that for almost 38% of the days the insulin dose was less than 8 IU. (4) Conclusions: The AHCL system allows safe and effective insulin therapy in automatic mode, as well as in patients with a lower daily insulin requirement. The AHCL system should be considered a good therapeutic option for patients from the onset of T1D, as well in the remission phase.

Keywords: advanced hybrid closed loop systems; borderline total daily dose of insulin; remission; type 1 diabetes mellitus.

Publication types

  • Case Reports

MeSH terms

  • Blood Glucose
  • Blood Glucose Self-Monitoring
  • Child
  • Diabetes Mellitus, Type 1* / drug therapy
  • Humans
  • Hypoglycemic Agents
  • Insulin
  • Insulin Infusion Systems
  • Male

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin