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How to use 780G advanced hybrid closed loop system most effectively and avoid disappointments? Some practical tips from first experiences

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letter to the editor iSSN 2450–7458

234

Address for correspondence:

Tomasz Klupa

Center for Advanced Technologies in Diabetes Department of Metabolic Diseases

Jagiellonian University Medical College Kraków, Poland

e-mail:tomasz.klupa@uj.edu.pl

Clinical Diabetology 2021, 10; 2: 234–235 DOI: 10.5603/DK.a2021.0018

Received: 31.01.2021 Accepted: 03.02.2021

Tomasz Klupa

Center for Advanced Technologies in Diabetes, Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland University Hospital in Krakow, Krakow, Poland

how to use 780g advanced hybrid closed loop system most effectively and avoid disappointments? Some practical tips from first experiences

In recent weeks, we have seen the emergence of the MiniMed 780G, an advanced hybrid insulin pump system, on several European markets.

The effectiveness of this system has been well docu- mented in clinical trials; however, it seems important for an individual user to highlight a few points that are crucial for optimizing treatment with the MiniMed 780G pump.

According to the author of the letter, these include:

— Bolus Calculator settings should be slightly more

“aggressive” than in previously used systems, but not “too aggressive”, because the device consid- ers the suggested dose of insulin to be too ex- cessive and so will not give the assumed dose of insulin.

— The patient starting treatment with the 780G pump should remain in manual mode for at least 5–7 days before going into “SmartGuard” mode.

One also needs to remember to reset the pump if it was used for training purposes before con- necting it.

— Keep in mind that although in SmartGuard mode it is possible to achieve a very good glycemic con- trol of diabetes, it will not be “normoglycemia!”

— The patient should be prepared for the fact that after administration of the prandial bolus, for safety and protection against hypoglycemia, the pump will hold the base. As a result initially pa- tients can experience moderate, late post-meal hyperglycemia.

— In SmartGuard mode, the pump “learns” the pat- terns of glycemia, patterns of patient’s behavior.

Over time, the control of diabetes will get better.

— Pump learning mode is a two-week mode (this is especially important when making changes to the device settings).

— If the patient observes significant increases in post-meal glycemia in up to 2 h after a meal — he or she may type slightly larger (20–30%) the amount of grams of carbohydrates compared to the actually consumed.

— If post-meal glycemia increases within 2–4 hours after a meal — this is probably the effect of eat- ing a meal high in fat: in such a situation, before meals, you need to enter the amount of grams of carbohydrates realistically calculated per meal, after 2 hours, again enter carbohydrates in the amount of 30% of the amount introduced before meals (the author suggests the rule: rule 100%–

2h–30%) — we count only carbohydrates!

— Real time from “manual mode” to obtaining optimal glucose patterns in SmartGuard mode — 4 weeks.

It seems that taking into account these simple guidelines resulting from the author’s first experience with MiniMed 780G systems, on the one hand, will allow patients to avoid unnecessary disappointments and frustrations, especially at the beginning of therapy, on the other hand, will make the treatment with the

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Tomasz Klupa, Practical tips for MiniMed 780G users

235 system the most effective, allowing to take full ad-

vantage of this advanced hybrid closed loop personal insulin pump.

Conflict of interest

Advisory Board Panel and Speakers Bureau — Medtronic.

REFERENCES

1. Carlson AL, et al. 97-P-Safety and glycemic outcomes of the MiniMed AHCL System in subjects with T1D. 80th ADA Inter- national Conference, June 2020, Chicago.

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