Is Automated Insulin Delivery System Therapy Safe and Effective in Children Under Seven Years Old?

Objective: To evaluate the off-label use of the MiniMed™ 780G system in children under seven years old, as clinical outcomes in this age group are less well-established, despite the improvements in glycemic control seen with MiniMed™ 780G therapy. Methods: Children under seven years old with type 1...

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Main Authors: Nihal Gül Uslu, Deniz Özalp Kızılay, Günay Demir, Yasemin Atik Altınok, Şükran Darcan, Samim Özen, Damla Gökşen
Format: Article
Language:English
Published: Galenos Yayincilik 2025-06-01
Series:JCRPE
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Online Access:https://www.jcrpe.org/articles/is-automated-insulin-delivery-system-therapy-safe-and-effective-in-children-under-seven-years-old/doi/jcrpe.galenos.2024.2024-11-2
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author Nihal Gül Uslu
Deniz Özalp Kızılay
Günay Demir
Yasemin Atik Altınok
Şükran Darcan
Samim Özen
Damla Gökşen
author_facet Nihal Gül Uslu
Deniz Özalp Kızılay
Günay Demir
Yasemin Atik Altınok
Şükran Darcan
Samim Özen
Damla Gökşen
author_sort Nihal Gül Uslu
collection DOAJ
description Objective: To evaluate the off-label use of the MiniMed™ 780G system in children under seven years old, as clinical outcomes in this age group are less well-established, despite the improvements in glycemic control seen with MiniMed™ 780G therapy. Methods: Children under seven years old with type 1 diabetes using MiniMed™ 780G pump therapy were compared with children of similar age and gender using MiniMed™ 640G insulin pump therapy and multiple-dose insulin therapy with continuous glucose monitoring systems (CGMs). CGM metrics, total daily insulin (TDI) dose, and hemoglobin A1c (HbA1c) levels were evaluated retrospectively at baseline and at the 3rd, 6th, and 12th months. Results: At the initiation of MiniMed™ 780G therapy, the mean age was 5.25±1.22 years (range: 2.8-6.8 years), and the mean TDI was 10.12±4.34 U/day (range: 4.5-17.0 U/day). The glucose management indicator and HbA1c remained lower in the MiniMed™ 780G group at the 3rd, 6th, and 12th months compared to baseline (p=0.009 and p<0.001, respectively). In the MiniMed™ 780G group, time above range (TAR) was significantly lower at the 3rd, 6th, and 12th months (p=0.018, p=0.017 and p=0.04, respectively) while time in range (TIR) was higher at the 3rd, and 12th months (p=0.026 and p=0.019, respectively) compared to other groups. The coefficient of variation (CV) of the sensor glucose and HbA1c were lower at the 12th month (p=0.008 and p=0.015, respectively) compared to both other groups. No instances of ketoacidosis or severe hypoglycemic events were observed in any of the children during the follow-up period. Conclusion: The absence of significantly higher levels of hypoglycemia compared to other groups at any time point, along with a significant decrease in TAR across all time points, a significant increase in TIR at the 3rd and 12th months, and a significant decrease in HbA1c and CV suggests that the MiniMed™ 780G system is both safe and effective for children under seven years old.
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spelling doaj-art-8a14a0b20ee3412bbfc99e562ba9a7852025-08-20T03:46:45ZengGalenos YayincilikJCRPE1308-57271308-57352025-06-0117215316010.4274/jcrpe.galenos.2024.2024-11-2Is Automated Insulin Delivery System Therapy Safe and Effective in Children Under Seven Years Old?Nihal Gül Uslu0https://orcid.org/0009-0003-9091-4032Deniz Özalp Kızılay1https://orcid.org/0000-0003-4529-4404Günay Demir2https://orcid.org/0000-0003-1468-1647Yasemin Atik Altınok3https://orcid.org/0000-0001-5851-1012Şükran Darcan4https://orcid.org/0000-0002-1330-6397Samim Özen5https://orcid.org/0000-0001-7037-2713Damla Gökşen6https://orcid.org/0000-0001-6108-0591Ege University Faculty of Medicine Department of Pediatrics, Clinic of Pediatric Endocrinology, İzmir, TürkiyeEge University Faculty of Medicine Department of Pediatrics, Clinic of Pediatric Endocrinology, İzmir, TürkiyeEge University Faculty of Medicine Department of Pediatrics, Clinic of Pediatric Endocrinology, İzmir, TürkiyeEge University Faculty of Medicine Department of Pediatrics, Clinic of Pediatric Endocrinology, İzmir, TürkiyeEge University Faculty of Medicine Department of Pediatrics, Clinic of Pediatric Endocrinology, İzmir, TürkiyeEge University Faculty of Medicine Department of Pediatrics, Clinic of Pediatric Endocrinology, İzmir, TürkiyeEge University Faculty of Medicine Department of Pediatrics, Clinic of Pediatric Endocrinology, İzmir, TürkiyeObjective: To evaluate the off-label use of the MiniMed™ 780G system in children under seven years old, as clinical outcomes in this age group are less well-established, despite the improvements in glycemic control seen with MiniMed™ 780G therapy. Methods: Children under seven years old with type 1 diabetes using MiniMed™ 780G pump therapy were compared with children of similar age and gender using MiniMed™ 640G insulin pump therapy and multiple-dose insulin therapy with continuous glucose monitoring systems (CGMs). CGM metrics, total daily insulin (TDI) dose, and hemoglobin A1c (HbA1c) levels were evaluated retrospectively at baseline and at the 3rd, 6th, and 12th months. Results: At the initiation of MiniMed™ 780G therapy, the mean age was 5.25±1.22 years (range: 2.8-6.8 years), and the mean TDI was 10.12±4.34 U/day (range: 4.5-17.0 U/day). The glucose management indicator and HbA1c remained lower in the MiniMed™ 780G group at the 3rd, 6th, and 12th months compared to baseline (p=0.009 and p<0.001, respectively). In the MiniMed™ 780G group, time above range (TAR) was significantly lower at the 3rd, 6th, and 12th months (p=0.018, p=0.017 and p=0.04, respectively) while time in range (TIR) was higher at the 3rd, and 12th months (p=0.026 and p=0.019, respectively) compared to other groups. The coefficient of variation (CV) of the sensor glucose and HbA1c were lower at the 12th month (p=0.008 and p=0.015, respectively) compared to both other groups. No instances of ketoacidosis or severe hypoglycemic events were observed in any of the children during the follow-up period. Conclusion: The absence of significantly higher levels of hypoglycemia compared to other groups at any time point, along with a significant decrease in TAR across all time points, a significant increase in TIR at the 3rd and 12th months, and a significant decrease in HbA1c and CV suggests that the MiniMed™ 780G system is both safe and effective for children under seven years old.https://www.jcrpe.org/articles/is-automated-insulin-delivery-system-therapy-safe-and-effective-in-children-under-seven-years-old/doi/jcrpe.galenos.2024.2024-11-2automated delivery systemdiabetesdiabetes mellitusendocrinologypredictive low glucose suspension
spellingShingle Nihal Gül Uslu
Deniz Özalp Kızılay
Günay Demir
Yasemin Atik Altınok
Şükran Darcan
Samim Özen
Damla Gökşen
Is Automated Insulin Delivery System Therapy Safe and Effective in Children Under Seven Years Old?
JCRPE
automated delivery system
diabetes
diabetes mellitus
endocrinology
predictive low glucose suspension
title Is Automated Insulin Delivery System Therapy Safe and Effective in Children Under Seven Years Old?
title_full Is Automated Insulin Delivery System Therapy Safe and Effective in Children Under Seven Years Old?
title_fullStr Is Automated Insulin Delivery System Therapy Safe and Effective in Children Under Seven Years Old?
title_full_unstemmed Is Automated Insulin Delivery System Therapy Safe and Effective in Children Under Seven Years Old?
title_short Is Automated Insulin Delivery System Therapy Safe and Effective in Children Under Seven Years Old?
title_sort is automated insulin delivery system therapy safe and effective in children under seven years old
topic automated delivery system
diabetes
diabetes mellitus
endocrinology
predictive low glucose suspension
url https://www.jcrpe.org/articles/is-automated-insulin-delivery-system-therapy-safe-and-effective-in-children-under-seven-years-old/doi/jcrpe.galenos.2024.2024-11-2
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