Startseite Adolescents with type 1 diabetes vs. hybrid closed loop systems: a case series of patients’ behaviour that challenges the algorithm.
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Adolescents with type 1 diabetes vs. hybrid closed loop systems: a case series of patients’ behaviour that challenges the algorithm.

  • Angela Zanfardino ORCID logo EMAIL logo , Alessia Piscopo , Pietro Gizzone , Caterina Vitulano , Federica Di Gennaro , Giulia Buccella , Irma Fabozzi , Gabriella Mainolfi , Mariagrazia Bathilde Marongiu , Assunta S. Rollato , Veronica Testa , Antonietta Chianese , Emanuele Miraglia del Giudice , Alda Troncone und Dario Iafusco
Veröffentlicht/Copyright: 14. Dezember 2022
Journal of Pediatric Endocrinology and Metabolism
Aus der Zeitschrift Journal of Pediatric Endocrinology and Metabolism Band 36 Heft 2

Abstract

Objectives

Hybrid closed loop systems (HCL) improve the management of type 1 diabetes (T1DM). T1DM adolescent patients represent a risk category also if they are in an automated insulin infusion delivery therapy.

Case presentation

We describe a series of four cases in which adolescent patients have adopted incorrect behaviours in the managing of HCL systems, challenging the algorithm skills. Two patients performed fabricated sensor calibrations. The other two did not perform pre-prandial insulin boluses correctly. Despite these behaviours, the algorithm corrected the glucose values in three out of four patients. Only in one case, where fabricated calibrations were too frequent, the automatic system failed to restore the glycemic balance.

Conclusions

Fabricated calibrations seem to be more important than uncorrected insulin boluses to challenge the HCL systems.

Keywords: adolescents; hybrid closed loop systems; type 1 diabetes
Corresponding author: Angela Zanfardino, MD, Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, via Sant’Andrea delle Dame, 4, 80138, Naples, Italy, Phone: +39 081 5665434, Fax: +39 081 5665472, E-mail:

  1. Research funding: None declared.

  2. Author contribution: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: A.Z., A.P., P.G., C.V., F.D.G., G.B., I.F., G.M., M.B.M., A.S.R., A.C., E.M.G., A.T., D.I. have no financial or other relationships that could lead to a conflict of interest. V.T. is an employee of Medtronic.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethics approval: The local Institutional Review Board deemed the study exempt from review.

References

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jpem-2022-0411).

Received: 2022-08-16
Revised: 2022-11-16
Accepted: 2022-11-17
Published Online: 2022-12-14
Published in Print: 2023-02-23

© 2022 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

  1. Frontmatter
  2. Review
  3. One half-century of advances in the evaluation and management of disorders of bone and mineral metabolism in children and adolescents
  4. Original Articles
  5. Safety and user experience with off-label use of a flash glucose monitor (FreeStyle Libre® 1) among very young children with type 1 diabetes mellitus
  6. Sonic hedgehog N-terminal level correlates with adiponectin level and insulin resistance in adolescents
  7. Elevated amylase and lipase levels in patients with DKA followed in the pediatric intensive care unit
  8. The relationship between alexithymia, health literacy, and diet quality in obese adolescents
  9. The role of the deficiency of vitamin B12 and folic acid on homocysteinemia in children with Turner syndrome
  10. Clinical spectrum and diagnostic challenges of vitamin D dependent rickets type 1A (VDDR1A) caused by CYP27B1 mutation in resource limited countries
  11. Comparative characteristics of developing morphofunctional features of schoolchildren from different climatic and geographical regions
  12. Leucine tolerance in children with MSUD is not correlated with plasma leucine levels at diagnosis
  13. Outcomes of children with severe diabetic ketoacidosis managed outside of a pediatric intensive care unit
  14. Thiamine status during treatment of diabetic ketoacidosis in children – tertiary care centre experience
  15. Premature adrenarche in Prader–Willi syndrome is associated with accelerated pre-pubertal growth and advanced bone age
  16. Short Communication
  17. Diagnosis of adrenal insufficiency in children: a survey among pediatric endocrinologists in North America
  18. Case Reports
  19. Pediatric growth hormone and prolactin-secreting tumor associated with an AIP mutation and a MEN1 variant of uncertain significance
  20. Two cases of MEGDHEL syndrome diagnosed with hyperammonemia
  21. Hyperinsulinism–hyperammonemia syndrome in two Peruvian children with refractory epilepsy
  22. A case report of a young boy with low renin and high aldosterone levels induced by Liddle syndrome who was previously misdiagnosed with primary aldosteronism
  23. Adolescents with type 1 diabetes vs. hybrid closed loop systems: a case series of patients’ behaviour that challenges the algorithm.
https://doi.org/10.1515/jpem-2022-0411
Schlagwörter für diesen Artikel
adolescents; hybrid closed loop systems; type 1 diabetes

Artikel in diesem Heft

  1. Frontmatter
  2. Review
  3. One half-century of advances in the evaluation and management of disorders of bone and mineral metabolism in children and adolescents
  4. Original Articles
  5. Safety and user experience with off-label use of a flash glucose monitor (FreeStyle Libre® 1) among very young children with type 1 diabetes mellitus
  6. Sonic hedgehog N-terminal level correlates with adiponectin level and insulin resistance in adolescents
  7. Elevated amylase and lipase levels in patients with DKA followed in the pediatric intensive care unit
  8. The relationship between alexithymia, health literacy, and diet quality in obese adolescents
  9. The role of the deficiency of vitamin B12 and folic acid on homocysteinemia in children with Turner syndrome
  10. Clinical spectrum and diagnostic challenges of vitamin D dependent rickets type 1A (VDDR1A) caused by CYP27B1 mutation in resource limited countries
  11. Comparative characteristics of developing morphofunctional features of schoolchildren from different climatic and geographical regions
  12. Leucine tolerance in children with MSUD is not correlated with plasma leucine levels at diagnosis
  13. Outcomes of children with severe diabetic ketoacidosis managed outside of a pediatric intensive care unit
  14. Thiamine status during treatment of diabetic ketoacidosis in children – tertiary care centre experience
  15. Premature adrenarche in Prader–Willi syndrome is associated with accelerated pre-pubertal growth and advanced bone age
  16. Short Communication
  17. Diagnosis of adrenal insufficiency in children: a survey among pediatric endocrinologists in North America
  18. Case Reports
  19. Pediatric growth hormone and prolactin-secreting tumor associated with an AIP mutation and a MEN1 variant of uncertain significance
  20. Two cases of MEGDHEL syndrome diagnosed with hyperammonemia
  21. Hyperinsulinism–hyperammonemia syndrome in two Peruvian children with refractory epilepsy
  22. A case report of a young boy with low renin and high aldosterone levels induced by Liddle syndrome who was previously misdiagnosed with primary aldosteronism
  23. Adolescents with type 1 diabetes vs. hybrid closed loop systems: a case series of patients’ behaviour that challenges the algorithm.
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