The Automatic Correction Boluses in an Advanced Hybrid Closed-Loop System: Algorithm Performance and Clinical Implications.

IF 3.7 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Science and Technology Pub Date : 2026-05-07 DOI:10.1177/19322968261446967

Giuseppe Papa, Rossella Cannarella, Concetta Finocchiaro, Massimiliano Anzaldi, Carmelo Gusmano, Roberto Palazzolo, Gianfranco Gruttadauria, Luca Patti, Donatella Lo Presti, Salvatore Scirè Calabrisotto, Andrea Tumminia, Rosita A Condorelli, Sandro La Vignera, Aldo E Calogero

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Abstract

Background: Automatic correction boluses (ABs) are a key feature of advanced hybrid closed-loop systems, yet their clinical relevance remains incompletely characterized.

Methods: We retrospectively analyzed insulin delivery and continuous glucose monitoring (CGM) data from 287 individuals with type 1 diabetes using the MiniMed 780G for ≥6 months with ≥80% auto-mode usage, recruited from four diabetes centers in Sicily. We quantified the contribution of ABs to total daily insulin dose (TDD) and total bolus insulin and evaluated associations with demographic factors, pump settings, and dietary habits using multivariate regression and receiver operating characteristic (ROC) analyses.

Results: ABs accounted for 18.3% of TDD and 33.1% of total bolus insulin. AB/TDD was higher in pediatric participants and inversely associated with diabetes duration and AID use. Active insulin time and carbohydrate intake independently predicted AB/TDD. Higher AB/TDD was associated with lower time in range, higher glucose variability, time above range, and GMI; in pediatric participants, it was also associated with reduced time below range. An AB/TDD ≤20.3% predicted TIR >70% (AUC 0.785) and ≤18.6% predicted GMI <7% (AUC 0.828).

Conclusions: ABs represent a substantial component of insulin delivery in MiniMed 780G users. Higher AB contribution is associated with poorer glycemic outcomes. Identified thresholds may support system optimization in clinical practice.

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先进混合闭环系统中的自动校正丸：算法性能和临床意义。

背景：自动纠正丸（ABs）是先进混合闭环系统的一个关键特征，但其临床相关性仍不完全明确。方法：我们回顾性分析来自西西里岛4个糖尿病中心的287例使用MiniMed 780G≥6个月且≥80%自动模式使用的1型糖尿病患者的胰岛素输送和连续血糖监测（CGM）数据。我们量化了抗体对每日总胰岛素剂量（TDD）和总胰岛素量的贡献，并利用多变量回归和受试者工作特征（ROC）分析评估了其与人口统计学因素、泵设置和饮食习惯的关系。结果：抗体占总胰岛素用量的18.3%，占总胰岛素用量的33.1%。AB/TDD在儿科参与者中较高，与糖尿病持续时间和AID使用呈负相关。胰岛素活性时间和碳水化合物摄入量独立预测AB/TDD。较高的AB/TDD与较低的停留时间、较高的血糖变异性、停留时间和GMI相关；在儿科参与者中，它也与低于范围的时间缩短有关。AB/TDD≤20.3%预测TIR为70% (AUC为0.785),≤18.6%预测GMI。结论：在MiniMed 780G患者中，ABs是胰岛素输送的重要组成部分。较高的AB贡献与较差的血糖结果相关。确定的阈值可以在临床实践中支持系统优化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes Science and Technology Medicine-Internal Medicine

CiteScore

7.50

自引率

12.00%

发文量

148

期刊介绍： The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.