Abstract
This cross-sectional real-world study determined the frequency and severity of rebound hyperglycemia (RH) and its association with glucose metrics in children and adolescents with type 1 diabetes (T1D) using automated insulin delivery (AID) systems. Continuous glucose monitoring data were analyzed from participants <18-years with T1D using Tandem Control-IQ (CIQ) or Medtronic MiniMed 780G (780G). RH was defined as sensor glucose (SG) >10.0 mmol/L within 2 h after hypoglycemia (SG <3.9 mmol/L). RH-severity was assessed as area under the SG-curve above 10.0 mmol/L. Among 190 participants (84 females, 94 CIQ-users, mean age: 11 ± 2 years, and HbA1c: 53.9 ± 10.3 mmol/mol), 9.4 ± 5.5 hypoglycemia events occurred weekly; 41% led to RH. RH-frequency was similar between systems, but RH-severity was lower with 780G (P = 0.02). Greater RH-severity was associated with lower time-in-range and higher glycemic variability. In conclusion, RH was common and associated with adverse glucose outcomes. Optimizing hypoglycemia treatment may reduce RH regardless of the AID system.
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