REVIEW  UPDATE IN PEDIATRIC DIABETES AND ENDOCRINOLOGY: PROCEEDING OF THE 7TH WINTER AND SUMMER ISPED SCHOOL FOR PHYSICIANS 

Minerva Pediatrics 2021 December;73(6):474-85

DOI: 10.23736/S2724-5276.21.06531-9

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Efficacy of advanced hybrid closed loop systems for the management of type 1 diabetes in children

Lucia FERRITO ¹, Stefano PASSANISI ², Riccardo BONFANTI ³, Valentino CHERUBINI ⁴, Nicola MINUTO ⁵, Riccardo SCHIAFFINI ⁶, Andrea SCARAMUZZA ⁷ ✉

¹ Division of Pediatrics and Neonatology, Hospital of Senigallia, Senigallia, Ancona, Italy; ² Department of Human Pathology in Adult and Developmental Age, University of Messina, Messina, Italy; ³ Department of Pediatrics, Diabetes Research Institute, IRCCS San Raffaele Hospital, Milan, Italy; ⁴ Department of Women’s and Children’s Health, G. Salesi Hospital, Ancona, Italy; ⁵ Clinic of Pediatrics, IRCCS G. Gaslini, Genoa, Italy; ⁶ Unit of Diabetes, Bambino Gesù Children’s Hospital, Rome, Italy; ⁷ Unit of Pediatric Diabetes, Endocrinology and Nutrition, Division of Pediatrics, ASST Cremona, Cremona, Italy

Over the last years significant advances have been achieved in the development of technologies for diabetes management. Continuous subcutaneous insulin infusion (CSII), continuous glucose monitoring (CGM), predictive low glucose management (PLGM), hybrid closed loop (HCL) and advanced hybrid closed loop (AHCL) systems allow better diabetes management, thus reducing the burden of the disease and the risk of chronic complications. This review summarizes the main characteristics of the currently available HCL and AHCL systems and their primary effects in children and adolescents with type 1 diabetes (T1D). The findings of trials assessing the glucose control (time in range, HbA1c values, hypoglycemic events), the health-related quality of life and the existing limits of the use of these technologies are reported. The most recent data clearly confirm the ability of the HCL and AHCL insulin delivery systems to safely achieve a significant improvement of glucose control and quality of life in the pediatric population with T1D. Further studies are underway to overcame current barriers and future improvements in the usability of these technologies are awaited to facilitate their use in the routine clinical practice. The HCL and AHCL algorithms are the key features of today’s insulin delivery systems that mark a crucial step towards fully automated closed loop systems.

KEY WORDS: Pancreas artificial; Diabetes mellitus, type 1; Child