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Povzetek: Aim The efficacy of hybrid closed-loop systems (HCLs) in managing glycemic control in pregnant women with type 1 diabetes remains inadequately characterized. We evaluated the use of the Medtronic Minimed 780G HCLs. Methods: The retrospective observational study analyzed the glycemic and perinatal outcomes of pregnant women using the HCLs, followed at our tertiary centre. Independent t-tests were employed to compare data among trimesters based on pre-pregnancy HbA1c. The associations between glycemic parameters and perinatal outcomes were explored using Spearman rho. Results: Among the 21 women (age: 33.5 ± 4.2 years, diabetes duration: 21.2 ± 7.6 years, pre-pregnancy HbA1c 7.0 ± 1.1 % (52.9 ± 11.9 mmol/mol)) time in range (pTIR, 63–140 mg/dl; 3.5–7.8 mmol/l) increased progressively throughout pregnancy (trimesters: first: 64.0 ± 9.0 %; second:71.3 ± 11.8 %; third: 75.7 ± 8.1 %). Simultaneously, mean sensor glucose decreased (trimesters: first: 130 ± 10.4 mg/dl (7.2 ± 0.6 mmol/l); second: 120.9 ± 13.4 mg/dl (6.7 ± 0.7 mmol/l); third: 117.3 ± 9.1 mg/dl (6.5 ± 0.5 mmol/l)). Although a majority of women achieved the target pTIR until the third trimester, this did not consistently prevent the delivery of a largefor-gestational-age baby. Notably, one ketoacidosis event occurred, and there were no reported instances of severe hypoglycemia. Conclusion: Use of the Minimed 780G HCLs enabled the attainment of recommended pregnancy glycemic targets for most women with type 1 diabetes in a real-world setting.
Ključne besede: Type 1 diabetes, pregnancy continuous glucose monitoring, closed-loop insulin delivery
Objavljeno v DiRROS: 11.06.2026; Ogledov: 216; Prenosov: 256
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Povzetek: Regular physical activity and exercise (PA) are cornerstones of diabetes care for individuals with type 1 diabetes. In recent years, the availability of automated insulin delivery (AID) systems has improved the ability of people with type 1 diabetes to achieve the recommended glucose target ranges. PA provides additional health benefits but can cause glucose fluctuations, which challenges current AID systems. While an increasing number of clinical trials and reviews are being published on different AID systems and PA, it seems prudent at this time to collate this information and develop a position statement on the topic. This joint European Association for the Study of Diabetes (EASD)/International Society for Pediatric and Adolescent Diabetes (ISPAD) position statement reviews current evidence on AID systems and provides detailed clinical practice points for managing PA in children, adolescents and adults with type 1 diabetes using AID technology. It discusses each commercially available AID system individually and provides guidance on its use in PA. Additionally, it addresses different glucose responses to PA and provides stratified therapy options to maintain glucose levels within the target ranges for these age groups.
Ključne besede: automated insulin delivery, continuous glucose monitoring, exercise, glucose, insulin pump, physical activity, position statement, type 1 diabetes
Objavljeno v DiRROS: 23.04.2026; Ogledov: 326; Prenosov: 349
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Povzetek: Continuous glucose monitoring (CGM) is now central to diabetes management, yet variation in how respective medical products are evaluated limits meaningful comparison between CGM systems. Three barriers currently constrain reliable interpretation of glucose-derived measures. The first is limited transparency: in several regulatory settings, particularly those using Conformité Européenne marking, clinical-study reports, reference-method information and analytical documentation required for market authorisation are not publicly accessible. The second barrier is heterogeneity in study procedures. Existing evaluations use different reference-glucose methods, sampling strategies, glucose-manipulation protocols and participant characteristics, leading to accuracy estimates that cannot be interpreted consistently across systems. The third barrier is calibration alignment. Even with full transparency and aligned procedures, CGM systems may differ because their calibration algorithms are trained on distinct reference-glucose datasets, influencing reported glucose ranges, automated insulin-delivery behaviour and interpretation during device transitions. A modified Delphi process involving clinicians, laboratory scientists, and researchers identified these issues as the principal determinants of comparability. During this process, the International Federation of Clinical Chemistry and Laboratory Medicine released a validated framework for performance evaluation of CGM systems, providing a unified approach to reference-method selection, dynamic in-clinic testing, and structured reporting. Adoption would reduce procedural variability but does not resolve calibration-alignment differences. This international clinical opinion proposes a pathway towards internationally interpretable CGM evaluation: immediate transparency of clinical evidence, routine declaration of calibration alignment, and progressive adoption of validated standardised procedures. These steps provide a foundation for reliable interpretation and globally comparable assessment of CGM technologies.
Ključne besede: continuous glucose monitoring, CGM, diabetes management, evaluation
Objavljeno v DiRROS: 19.03.2026; Ogledov: 409; Prenosov: 381
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Povzetek: Background: The Time In Range (TIR) represents the amount of time spent by a given individual in the range close to normoglycemia, i.e. 70-180 mg/dl. On the basis of studies demonstrating an association of TIR with the incidence of diabetes complications, guidelines recommend a target of at least 70% of TIR for most people with diabetes. However, no study has explored the effect of variable degrees of TIR on molecular mechanisms relevant for the development of diabetes complications. Methods: We exposed endothelial cells and monocytes to increasing percentages of TIR, i.e. 50%, 70%, 85% by changing cell media twice a day as appropriate, as well as to constant normoglycemia (i.e. fixed 100 mg/dl of glucose for endothelial cells) and hyperglycemia (i.e. 500 mg/dl glucose), evaluating the development of senescence, of the associated pro-inflammatory response, and monocytes adhesion to endothelial cells as a functional assay. We then assessed the expression of a plethora of markers of senescence and inflammation at the mRNA level in peripheral blood mononuclear cells (PBMC)s derived from individuals with early (i.e. 1-year post-diagnosis) type 1 diabetes (T1D, n = 37), categorized according to the TIR (< or > 70%) observed in the previous 14 days, comparing the two groups through ANCOVA adjusted for HbA1c. As a confirmatory analysis, we also compared the expression of the same markers in people with Time Above Range (TAR), considered as the whole time above 180 mg/dl, ≥ vs < 30%. Correlations between TIR values and the expression of the same markers were tested through linear regression. Results: Constant hyperglycemia promoted the development of senescence in endothelial cells and induced inflammatory responses in both endothelial cells and monocytes, promoting also monocytes adhesion to endothelial cells. A TIR of 70%, but not of 50%, suppressed these effects while a TIR of 85% did not provide additional benefit. Data from people with T1D mirrored such results, as demonstrated by the higher expression of p16, a marker of senescence, and of IL-6, MCP-1, and CXCL1, three inflammatory mediators, in PBMCs from individuals with TIR < 70% and compared with those with TIR > 70%, independently of HbA1c. Similar results were obtained when comparing people with TAR ≥ vs < 30%. When considered as a continuous variable, TIR values were correlated with p16, IL-6, and CXCL1. Conclusions: A TIR above 70% is associated with attenuated pro-senescence and pro-inflammatory effects of hyperglycemia. These molecular results support the TIR target currently recommended by guidelines, especially for people with T1D.
Ključne besede: continuous glucose monitoring, TIR, TAR, hyperglycemia, inflammation, senescence, endothelial cells, monocytes, type 1 diabetes, PBMC
Objavljeno v DiRROS: 19.02.2026; Ogledov: 548; Prenosov: 270
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Ključne besede: continuous glucose monitoring, devices, market authorization, eCGM'compliance status
Objavljeno v DiRROS: 09.12.2025; Ogledov: 486; Prenosov: 322
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