This 12-week, open-label, randomised controlled trial compared precise carbohydrate counting with a simplified meal announcement strategy in adolescents initiating on the MiniMed 780G advanced hybrid closed-loop system. The simplified plan involved users choosing one of three personalised, fixed carbohydrate amounts according to meal size (regular, larger than normal or snack) for each meal announcement.
A total of 34 young adults with type 1 diabetes (age 12–18 years) were randomised 1:1 to simplified meal announcement or to precise carbohydrate counting following a week-long training and induction period. At 12 weeks, time in range (TIR) significantly improved in both groups: from 47.5% to 73.5% in the simplified group, and from 49.1% to 80.3% in the carb counting group (between-group difference 6.8%; P<0.05). Time below range was similar in the two groups; however, time above range was superior (2.7% lower) in the carb counting group. No serious adverse events occurred.
The authors note that, although precise carbohydrate counting resulted in superior glycaemic control, the simplified meal announcement strategy still enabled most participants to achieve international TIR targets, and thus they conclude that the latter may be a useful alternative for adolescents who struggle with conventional carbohydrate counting.
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9 Nov 2023