Glycemic Outcomes Following a Missed Premeal Bolus: A Comparative Study of Three Automated Insulin Delivery Systems in Children with Type 1 Diabetes.

IF 7.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes technology & therapeutics Pub Date : 2026-08-01 Epub Date: 2026-02-05 DOI:10.1177/15209156251415187

Alzbeta Santova, Lukas Plachy, Vit Neuman, Shenali Anne Amaratunga, Matvei G Slavenko, Barbora Obermannova, Lenka Drnkova, Stepanka Pruhova, Zdenek Sumnik

{"title":"Glycemic Outcomes Following a Missed Premeal Bolus: A Comparative Study of Three Automated Insulin Delivery Systems in Children with Type 1 Diabetes.","authors":"Alzbeta Santova, Lukas Plachy, Vit Neuman, Shenali Anne Amaratunga, Matvei G Slavenko, Barbora Obermannova, Lenka Drnkova, Stepanka Pruhova, Zdenek Sumnik","doi":"10.1177/15209156251415187","DOIUrl":null,"url":null,"abstract":"Objective: Missing premeal boluses negatively impacts glycemic outcomes in automated insulin delivery (AID) users. This prospective interventional study compared postprandial glycemia after missed bolus across three AID systems in children with type 1 diabetes (CwD).Methods: CwD using MiniMed 780G (780G), Tandem Control-IQ (CIQ), or Ypsomed CamAPS (CamAPS) consumed 30 g and 50 g of carbohydrates (CH) in the form of standardized enteral nutrition, purposely omitting a premeal bolus. The mean area under the curve (AUC) of glucose concentration change and continuous glucose monitoring metrics were analyzed over 4 h postprandially and compared between the systems.Results: Forty-three CwD completed the study (mean age = 13 years, mean HbA1c = 47 mmol/mol [6.5%]). The lowest mean AUC was reached by 780G, followed by CIQ and CamAPS (137 vs. 144 vs. 156 mmol/L·sec·103, P < 0.01). Similar trends were seen after 50 g of CH. CamAPS users spent more time in level 2 hyperglycemia (26% for 30 g, 42% for 50 g) compared to CIQ (9.9% and 26%) and 780G (5.0% and 21%; P < 0.001).Conclusions: AID systems differ in their capacity to compensate for missed premeal boluses. 780G and CIQ outperformed CamAPS in limiting postprandial hyperglycemia, suggesting they may be preferable for CwD prone to bolus omission.","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":"828-836"},"PeriodicalIF":7.4000,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes technology & therapeutics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/15209156251415187","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/2/5 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: Missing premeal boluses negatively impacts glycemic outcomes in automated insulin delivery (AID) users. This prospective interventional study compared postprandial glycemia after missed bolus across three AID systems in children with type 1 diabetes (CwD).

Methods: CwD using MiniMed 780G (780G), Tandem Control-IQ (CIQ), or Ypsomed CamAPS (CamAPS) consumed 30 g and 50 g of carbohydrates (CH) in the form of standardized enteral nutrition, purposely omitting a premeal bolus. The mean area under the curve (AUC) of glucose concentration change and continuous glucose monitoring metrics were analyzed over 4 h postprandially and compared between the systems.

Results: Forty-three CwD completed the study (mean age = 13 years, mean HbA1c = 47 mmol/mol [6.5%]). The lowest mean AUC was reached by 780G, followed by CIQ and CamAPS (137 vs. 144 vs. 156 mmol/L·sec·10³, P < 0.01). Similar trends were seen after 50 g of CH. CamAPS users spent more time in level 2 hyperglycemia (26% for 30 g, 42% for 50 g) compared to CIQ (9.9% and 26%) and 780G (5.0% and 21%; P < 0.001).

Conclusions: AID systems differ in their capacity to compensate for missed premeal boluses. 780G and CIQ outperformed CamAPS in limiting postprandial hyperglycemia, suggesting they may be preferable for CwD prone to bolus omission.

查看原文本刊更多论文

错过餐前注射后的血糖结局：1型糖尿病儿童三种自动胰岛素输送系统的比较研究

目的：缺少餐前剂量会对自动胰岛素输送（AID）使用者的血糖结局产生负面影响。这项前瞻性干预性研究比较了三种AID系统中1型糖尿病（CwD）患儿未给药后的餐后血糖。方法：CwD使用MiniMed 780G (780G), Tandem Control-IQ （CIQ）或Ypsomed CamAPS (CamAPS)，以标准化肠内营养的形式消耗30 g和50 g碳水化合物（CH），故意省略餐前剂量。分析餐后4 h葡萄糖浓度变化的平均曲线下面积（AUC）和连续血糖监测指标，并比较两种系统之间的差异。结果：43名CwD完成研究（平均年龄13岁，平均HbA1c = 47 mmol/mol[6.5%]）。平均AUC最低的是780G，其次是CIQ和CamAPS （137 vs. 144 vs. 156 mmol/L·sec·103,P < 0.01）。与CIQ组（9.9%和26%）和780G组（5.0%和21%，P < 0.001）相比，服用50 g CH的CamAPS组患者出现2级高血糖的时间更长（30 g组为26%，50 g组为42%）。结论：AID系统补偿错过的餐前补剂的能力不同。780G和CIQ在限制餐后高血糖方面优于CamAPS，表明它们可能更适合易于遗漏的CwD。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Diabetes technology & therapeutics 医学-内分泌学与代谢

CiteScore

10.60

自引率

14.80%

发文量

145

审稿时长

3-8 weeks

期刊介绍： Diabetes Technology & Therapeutics is the only peer-reviewed journal providing healthcare professionals with information on new devices, drugs, drug delivery systems, and software for managing patients with diabetes. This leading international journal delivers practical information and comprehensive coverage of cutting-edge technologies and therapeutics in the field, and each issue highlights new pharmacological and device developments to optimize patient care.