Nicolò Diego Borella1 · Antonio Ferramosca2 · Giona Castagna1 · Silvia Ippolito1 · Sara Ceresoli2 · Antonio Taverna1 · Beatrice Sonzogni2 · Roberto Trevisan1,3 · Giuseppe Lepore1
Received: 6 March 2024 / Accepted: 15 October 2024 / Published online: 22 November 2024 © The Author(s) 2024
Abstract
Context Advanced hybrid closed loop (AHCL) systems currently represent the most advanced modality of insulin therapy.
Aim To compare the night-time (from 00 to 07 a.m.) effectiveness in achieving recommended glycemic targets of three dif-ferent AHCL systems in adults with type 1 diabetes (T1D).
Methods We retrospectively evaluated 55 adults with T1D (mean age 41±16 years, male 40%, diabetes duration 19.4±11.4 years, BMI 24.1±4.1 kg/m2 ) with similar glycemic control (GMI 7.0–7.4%). Twenty-two participants were using the Minimed 780G system, 18 the Tandem t:slim X2 with Control-IQ system and 15 the DBLG1 system. Continuous glucose monitoring derived metrics and insulin requirement of 14 consecutive nights were
Results All three groups achieved the recommended mean TIR>70%, mean TBR<4%, and mean CV<36% with a similar insulin requirement (Minimed 780G system: TIR 73.9±11.2%, TBR 0.9±1.2%, CV 29±6.7%; Tandem t:slim X2 with Con-trol-IQ system: TIR 74.1±11.1%, TBR 1.1±1.0%, CV 34.5±6.6%; DBLG1 System TIR 71.7±11.3%, TBR 1.4±3.7%, CV 32.4±7.1%). Tight TIR% (70–140 mg/dl) was significantly higher (p<0.01) in the Tandem t:slim X2 with Control-IQ group (51.5±9.8%) when compared to Minimed 780G group (42.1±13.7%) and DBLG1 System (40.1±10.5%). In all three groups the insulin infusion similarly decreased from midnight to 05.00 am and then increased.
Conclusions All the three AHCL systems achieved the recommended TIR, TBR and CV without difference in insulin requirement. The Tandem Control-IQ system obtained a higher tight TIR.
Oliver Kuss1,2,3 · Michael Roden3,4,5 · Sabrina Schlesinger1,3 · Annika Hoyer6
Received: 27 May 2024 / Accepted: 23 November 2024 / Published online: 12 December 2024 © The Author(s) 2024
Aims Two prerequisites must be met for the precision treatment approach to be beneficial for treated individuals. First, there must be treatment heterogeneity; second, in case of treatment heterogeneity, clinical predictors to identify people who would benefit from one treatment more than from others must be available. There is an established meta-regression approach to assess these two prerequisites that relies on measuring the variability of a clinical outcome after treatment in placebo-controlled randomised trials. We recently applied this approach to the treatment of type 2 diabetes for the clinical outcomes of glycaemic control and body weight and repeat it for the clinical outcome of all-cause mortality.
Methods We performed a meta-regression analysis using digitalized individual participant information on time to death from 10 large cardiovascular outcome trials (7563 deaths from 99,746 participants) on DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT-2 inhibitors with respect to the variability of all-cause mortality and its potential predictors after treatment.
Results The adjusted difference in log(SD) values of time to death between the verum and placebo arms was −0.036 (95%- CI: −0.059; −0.013), showing larger variability of time to death in the placebo arms. No clinical predictors were found to explain treatment heterogeneity.
Conclusions This analysis suggests that the potential of the precision treatment approach in type 2 diabetes is low, at least with regard to improvement of all-cause mortality in population with high cardiovascular risk. This extends our previous findings for the clinical outcomes of glycaemic control and body weight.
Keywords Dipeptidyl peptidase-4 inhibitors · Glucagon-like peptide 1 · HbA1c · Meta-regression · Precision medicine · Sodium–glucose transporter 2 inhibitors · Type 2 diabetes mellitus
原创： 十六点五 中山二院糖尿病足中心
梁某，女，60岁，糖尿病病史7年，平时不规则用药，血糖控制一般。10余天前不小心刺伤左脚第2趾，到当地医院看病，感染扩散，当地医院建议截肢，患者要求转院于2018年10月27日转入我院。
截肢与保肢只差一个中山二院的距离
原创： 血管工程师 血管工程师
胡奶奶今年73岁高龄，10年前发现糖尿病，血糖一直控制不佳，还有高血压等疾病，3年前因右下肢静脉曲张在当地医院做过手术。1月前因左下肢无力、麻木，当地医院考虑为左下肢静脉曲张再次入院行左下肢静脉曲张手术。
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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