Hoda Gad, Einas Elgassim, Kawsar Mohamed Ayon Mohamud, Najlaa Sultan Al-Naimi, Hamad Ali Al-Sharshani, Ibrahim Mohammed, Mariam A. Al-Malaheem, Dorothy J. Quadros, Alhanoof AlJalahma, Neila Lamine, Ahmad Yaser Alhaddad, Hussein Ahmed Hussein Zaky Aly, John-John Cabibihan, Abdulaziz Al-Ali, Kishor Kumar Sadasivuni, Ioannis N. Petropoulos, Georgios Ponirakis, Hamda A. Ali, Dabia AlMohanadi, Khaled Baagar, Rayaz A. Malik
{"title":"先进的混合型闭环胰岛素递送与成人1型糖尿病患者血糖指标改善和小神经纤维结构正常化相关","authors":"Hoda Gad, Einas Elgassim, Kawsar Mohamed Ayon Mohamud, Najlaa Sultan Al-Naimi, Hamad Ali Al-Sharshani, Ibrahim Mohammed, Mariam A. Al-Malaheem, Dorothy J. Quadros, Alhanoof AlJalahma, Neila Lamine, Ahmad Yaser Alhaddad, Hussein Ahmed Hussein Zaky Aly, John-John Cabibihan, Abdulaziz Al-Ali, Kishor Kumar Sadasivuni, Ioannis N. Petropoulos, Georgios Ponirakis, Hamda A. Ali, Dabia AlMohanadi, Khaled Baagar, Rayaz A. Malik","doi":"10.1111/jns.70026","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Patients with T1DM treated for 9.8 ± 0.32 months with the 780G SmartGuard system (<i>n</i> = 14) were compared with patients with T1DM on MDI (<i>n</i> = 20) and healthy controls (<i>n</i> = 15). Time in range (TIR), time above range (TAR), time below range (TBR), glycemic variability, and HbA<sub>1c</sub> 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).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Participants using the 780G system had a significantly higher TIR (<i>p</i> < 0.001), lower glycemic variability (<i>p</i> = 0.02), and less time in level 2 hyperglycemia (<i>p</i> = 0.01), level 1 hyperglycemia (<i>p</i> = 0.04), and level 2 hypoglycemia (<i>p</i> = 0.008) compared with the MDI group. CNFD (<i>p</i> = 0.02), CNBD (<i>p</i> = 0.04), CNFL (<i>p</i> = 0.04), and IWL (<i>p</i> < 0.001) were significantly higher in the 780G group compared with the MDI group and comparable to healthy controls.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The MiniMed 780G with SmartGuard improves glycemic control and variability with an improvement in small nerve fiber morphology in patients with DPN.</p>\n </section>\n </div>","PeriodicalId":17451,"journal":{"name":"Journal of the Peripheral Nervous System","volume":"30 2","pages":""},"PeriodicalIF":3.9000,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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\",\"authors\":\"Hoda Gad, Einas Elgassim, Kawsar Mohamed Ayon Mohamud, Najlaa Sultan Al-Naimi, Hamad Ali Al-Sharshani, Ibrahim Mohammed, Mariam A. Al-Malaheem, Dorothy J. Quadros, Alhanoof AlJalahma, Neila Lamine, Ahmad Yaser Alhaddad, Hussein Ahmed Hussein Zaky Aly, John-John Cabibihan, Abdulaziz Al-Ali, Kishor Kumar Sadasivuni, Ioannis N. Petropoulos, Georgios Ponirakis, Hamda A. Ali, Dabia AlMohanadi, Khaled Baagar, Rayaz A. Malik\",\"doi\":\"10.1111/jns.70026\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Patients with T1DM treated for 9.8 ± 0.32 months with the 780G SmartGuard system (<i>n</i> = 14) were compared with patients with T1DM on MDI (<i>n</i> = 20) and healthy controls (<i>n</i> = 15). Time in range (TIR), time above range (TAR), time below range (TBR), glycemic variability, and HbA<sub>1c</sub> 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).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Participants using the 780G system had a significantly higher TIR (<i>p</i> < 0.001), lower glycemic variability (<i>p</i> = 0.02), and less time in level 2 hyperglycemia (<i>p</i> = 0.01), level 1 hyperglycemia (<i>p</i> = 0.04), and level 2 hypoglycemia (<i>p</i> = 0.008) compared with the MDI group. CNFD (<i>p</i> = 0.02), CNBD (<i>p</i> = 0.04), CNFL (<i>p</i> = 0.04), and IWL (<i>p</i> < 0.001) were significantly higher in the 780G group compared with the MDI group and comparable to healthy controls.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>The MiniMed 780G with SmartGuard improves glycemic control and variability with an improvement in small nerve fiber morphology in patients with DPN.</p>\\n </section>\\n </div>\",\"PeriodicalId\":17451,\"journal\":{\"name\":\"Journal of the Peripheral Nervous System\",\"volume\":\"30 2\",\"pages\":\"\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2025-05-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the Peripheral Nervous System\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jns.70026\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Peripheral Nervous System","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jns.70026","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
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
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.
期刊介绍：
The Journal of the Peripheral Nervous System is the official journal of the Peripheral Nerve Society. Founded in 1996, it is the scientific journal of choice for clinicians, clinical scientists and basic neuroscientists interested in all aspects of biology and clinical research of peripheral nervous system disorders.
The Journal of the Peripheral Nervous System is a peer-reviewed journal that publishes high quality articles on cell and molecular biology, genomics, neuropathic pain, clinical research, trials, and unique case reports on inherited and acquired peripheral neuropathies.
Original articles are organized according to the topic in one of four specific areas: Mechanisms of Disease, Genetics, Clinical Research, and Clinical Trials.
The journal also publishes regular review papers on hot topics and Special Issues on basic, clinical, or assembled research in the field of peripheral nervous system disorders. Authors interested in contributing a review-type article or a Special Issue should contact the Editorial Office to discuss the scope of the proposed article with the Editor-in-Chief.
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