Effectiveness of MiniMed 640G with SmartGuard ® System for prevention of hypoglycemia in pediatric patients with type 1 diabetes mellitus

Introduction/aims: Treatment with the MiniMed 640G-SmartGuard (R) system (640G-SG, sensoraugmented insulin pump system with low predicted glucose suspension feature) has been shown to decrease risk of hypoglycemia without altering metabolic control in patients with T1DM. The study purpose was to assess the impact of 640G-SG on hipoglycemia frequency and on metabolic control in a pediatric population with T1DM. Patients/methods: A retrospective study on 21 children treated with 640G-SG. HbA1c, mean blood glucose (mg/dL), glucose variation coefficient, frequency of hypoglycemia (< 70 mg/dL) and hyperglycemia (> 180 mg/dL), daily capillary blood glucose measurements, ketosis/diabetic ketoacidosis, and severe hypoglycemic episodes were analyzed and compared before and during use of the system. Fasting blood glucose, frequency of sensor use and number and duration of system suspension events were also assessed in the last month of use of the system. Results: All patients used the system continuously (5.0 +/- 2.1 months), with a median sensor use of 92%. Significant decreases were seen in hypoglycemia frequency (10.4 +/- 5.2% to 7.6 +/- 3.3%, p = 0.044) and number of capillary blood glucose measurements (11.3 +/- 2.2 to 8.1 +/- 2.1, p < 0.001), and there was no increase in hyperglycemia frequency (p = 0.65). Mean system suspension time was 3.1 +/- 1.2 h/day (37.3% of overnight stops). Changes in HbA1c, mean blood glucose, and variation coefficient were not significant. No patient experienced diabetic ketoacidosis or severe hypoglycemia. Conclusions: The sensor-augmented pump with the predictive low glucose suspension management system, as implemented in the 640G-SG system, can help avoid risk of hypoglycemiawithout significantly affecting metabolic control or causing diabetic ketoacidosis, and decreasethe burden of additional capillary blood glucose measurements in our pediatric cohort. (C) 2017 SEEN. Published by Elsevier Espana, S.L.U. All rights reserved.