Journal of the peripheral nervous system : JPNS · 2025
Advanced Hybrid Closed-Loop Insulin Delivery Is Associated With Improved Glycemic Indicators and Normalization of Small Nerve Fibre Structure in Adults With Type 1 Diabetes.
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Gad Hoda, Elgassim Einas, Mohamud Kawsar Mohamed Ayon, Al-Naimi Najlaa Sultan, Al-Sharshani Hamad Ali, Mohammed Ibrahim, Al-Malaheem Mariam A, Quadros Dorothy J, AlJalahma Alhanoof, Lamine Neila, Alhaddad Ahmad Yaser, Aly Hussein Ahmed Hussein Zaky, Cabibihan John-John, Al-Ali Abdulaziz, Sadasivuni Kishor Kumar, Petropoulos Ioannis N, Ponirakis Georgios, Ali Hamda A, AlMohanadi Dabia, Baagar Khaled, Malik Rayaz A
Аннотация
BACKGROUND: Hyperglycemia is a major driver of diabetic peripheral neuropathy (DPN) in type 1 diabetes mellitus (T1DM). Advanced hybrid closed-loop (AHCL) technologies improve glycemic control and reduce glycemic variability and may improve DPN.
METHODS: Patients with T1DM treated for 9.8 ± 0.32 months with the 780G SmartGuard system (n = 14) were compared with patients with T1DM on MDI (n = 20) and healthy controls (n = 15). Time in range (TIR), time above range (TAR), time below range (TBR), glycemic variability, and HbA1c were evaluated, and corneal confocal microscopy (CCM) was undertaken to quantify corneal nerve fiber density (CNFD), branch density (CNBD), fiber length (CNFL), and inferior whorl length (IWL).
RESULTS: Participants using the 780G system had a significantly higher TIR (p < 0.001), lower glycemic variability (p = 0.02), and less time in level 2 hyperglycemia (p = 0.01), level 1 hyperglycemia (p = 0.04), and level 2 hypoglycemia (p = 0.008) compared with the MDI group. CNFD (p = 0.02), CNBD (p = 0.04), CNFL (p = 0.04), and IWL (p < 0.001) were significantly higher in the 780G group compared with the MDI group and comparable to healthy controls.
CONCLUSION: The MiniMed 780G with SmartGuard improves glycemic control and variability with an improvement in small nerve fiber morphology in patients with DPN.
METHODS: Patients with T1DM treated for 9.8 ± 0.32 months with the 780G SmartGuard system (n = 14) were compared with patients with T1DM on MDI (n = 20) and healthy controls (n = 15). Time in range (TIR), time above range (TAR), time below range (TBR), glycemic variability, and HbA1c were evaluated, and corneal confocal microscopy (CCM) was undertaken to quantify corneal nerve fiber density (CNFD), branch density (CNBD), fiber length (CNFL), and inferior whorl length (IWL).
RESULTS: Participants using the 780G system had a significantly higher TIR (p < 0.001), lower glycemic variability (p = 0.02), and less time in level 2 hyperglycemia (p = 0.01), level 1 hyperglycemia (p = 0.04), and level 2 hypoglycemia (p = 0.008) compared with the MDI group. CNFD (p = 0.02), CNBD (p = 0.04), CNFL (p = 0.04), and IWL (p < 0.001) were significantly higher in the 780G group compared with the MDI group and comparable to healthy controls.
CONCLUSION: The MiniMed 780G with SmartGuard improves glycemic control and variability with an improvement in small nerve fiber morphology in patients with DPN.