Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun 2;45(6):1486-1488.
doi: 10.2337/dc21-2643.

Carbohydrate Tolerance Threshold for Unannounced Snacks in Children and Adolescents With Type 1 Diabetes Using an Advanced Hybrid Closed-Loop System

Gianluca Tornese  1 , Claudia Carletti  1 , Manuela Giangreco  1 , Daniela Nisticò  2 , Elena Faleschini  1 , Egidio Barbi  1   2
Affiliations

Carbohydrate Tolerance Threshold for Unannounced Snacks in Children and Adolescents With Type 1 Diabetes Using an Advanced Hybrid Closed-Loop System

Gianluca Tornese et al. Diabetes Care. .

Abstract

Objective: To find a carbohydrate (CHO) tolerance threshold for unannounced snacks to avoid the 2 h increase in glycemia (difference between pre- and postmeal blood glucose [ΔBG]) ≥50 mg/dL in advanced hybrid closed-loop (a-HCL) users.

Research design and methods: Fourteen children and adolescents with type 1 diabetes (7 females; mean age [± SD] 14.5 ± 3.6 years), users of the Medtronic MiniMed 780G, participated in the study. For 12 days, they did not perform insulin bolus before breakfasts, with defined different quantities and types of CHO, with or without fats, performing blood glucose (BG) before and 2 h after the meal.

Results: A cutoff of 19.8 g of total CHO was found to determine a ΔBG of 50 mg/dL. BG never exceeded 250 mg/dL. Mean time in range was ≥70% in the 2 h following each snack.

Conclusions: Unannounced snacks of up to 20 g of CHO can avoid ΔBG ≥50 mg/dL in MiniMed 780G users, although unannounced meals of up to 30 g of CHO are safe.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Box plot with differences between blood glucose (BG) before and 2 h after unannounced snacks (ΔBG = 2-h postmeal BG − premeal BG).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Boughton CK, Hovorka R. New closed-loop insulin systems. Diabetologia 2021;64:1007–1015 - PMC - PubMed
    1. Bergenstal RM, Nimri R, Beck RW, et al. .; FLAIR Study Group . A comparison of two hybrid closed-loop systems in adolescents and young adults with type 1 diabetes (FLAIR): a multicentre, randomised, crossover trial. Lancet 2021;397:208–219 - PMC - PubMed
    1. Tornese G, Buzzurro F, Carletti C, Faleschini E, Barbi E. Six-month effectiveness of advanced vs. standard hybrid closed-loop system in children and adolescents with type 1 diabetes mellitus. Front Endocrinol (Lausanne) 2021;12:766314. - PMC - PubMed
    1. Collyns OJ, Meier RA, Betts ZL, et al. . Improved glycemic outcomes with Medtronic MiniMed advanced hybrid closed-loop delivery: results from a randomized crossover trial comparing automated insulin delivery with predictive low glucose suspend in people with type 1 diabetes. Diabetes Care 2021;44:969–975 - PubMed
    1. Mandal AK. In treating diabetes, what is important? Glucose levels or outcome measures? World J Diabetes 2015;6:1243–1245 - PMC - PubMed

Publication types