Diabetes technology & therapeutics · 2026
Hybrid Closed-Loop Disconnection Reduces the Risk of Hypoglycemia in Active Children and Adolescents with Type 1 Diabetes: A Randomized Controlled Pilot Study.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Chrzanowski Jędrzej, Olejniczak Aleksandra, Różycka Paulina, Michalak Arkadiusz, Fendler Wojciech, Szadkowska Agnieszka
Аннотация
INTRODUCTION: Optimizing hybrid closed-loop (HCL) performance around exercise in children with type 1 diabetes (T1D) is challenging.
METHODS: In this prospective, randomized, controlled pilot study conducted during a 7-day holiday camp, participants using Medtronic MiniMed 780 G and continuous glucose monitoring (CGM) were randomized to two strategies of HCL use for physical activity (1-2 sessions/day): pump kept connected in auto-mode versus suspended and disconnected. Meal boluses before exercise were not reduced, and all participants used 90-min pre-exercise temporary glucose target 150 mg/dL.
RESULTS: Of 20, 8 and 7 participants from connected and disconnected arms were eligible for analysis. Median age was 11 (10-11) years, diabetes duration was 1.6 (0.7-6.0) years, HbA1c was 6.4 (6.05-7.3)% (46, 43-56 mmol/mol), and BMI z-score was -0.25 (-0.53-1.36). HCL exercise disconnection resulted in lower time below range <70 mg/dL [3.9 mmol/L] during camp (-2.91 ± 1.3%point difference, P = 0.0250), with no difference in time in range 70-180 mg/dL [3.9-10.0 mmol/L] (+0.3 ± 4.8%point, P = 0.1677).
CONCLUSION: Temporary HCL disconnection for exercise significantly reduces hypoglycemia risk without compromising glucose control.
METHODS: In this prospective, randomized, controlled pilot study conducted during a 7-day holiday camp, participants using Medtronic MiniMed 780 G and continuous glucose monitoring (CGM) were randomized to two strategies of HCL use for physical activity (1-2 sessions/day): pump kept connected in auto-mode versus suspended and disconnected. Meal boluses before exercise were not reduced, and all participants used 90-min pre-exercise temporary glucose target 150 mg/dL.
RESULTS: Of 20, 8 and 7 participants from connected and disconnected arms were eligible for analysis. Median age was 11 (10-11) years, diabetes duration was 1.6 (0.7-6.0) years, HbA1c was 6.4 (6.05-7.3)% (46, 43-56 mmol/mol), and BMI z-score was -0.25 (-0.53-1.36). HCL exercise disconnection resulted in lower time below range <70 mg/dL [3.9 mmol/L] during camp (-2.91 ± 1.3%point difference, P = 0.0250), with no difference in time in range 70-180 mg/dL [3.9-10.0 mmol/L] (+0.3 ± 4.8%point, P = 0.1677).
CONCLUSION: Temporary HCL disconnection for exercise significantly reduces hypoglycemia risk without compromising glucose control.