Evidence mapPaperPMID 39215272Full record

Trial reportBMC endocrine disorders2024

Use of a decision support tool and quick start onboarding tool in individuals with type 1 diabetes using advanced automated insulin delivery: a single-arm multi-phase intervention study.

Shekhar Sehgal, Martin De Bock, Benyamin Grosman, Jonathan Williman, Natalie Kurtz, Vanessa Guzman, Andrea Benedetti, Anirban Roy, Kamuran Turksoy, Magaly Juarez and 5 more

Abstract readClinical TrialMulticenter Study
In one paragraph

Trial report in BMC endocrine disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. GHRH in diabetes and metabolism.Reviews in endocrine & metabolic disorders · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Shekhar SehgalDepartment of Women's and Children's Health, Dunedin School of Medicine, University of Otago, 201 Great King St, Dunedin, Otago, 9016, New Zealand.
Martin De BockDepartment of Paediatrics, Te Whatu Ora Waitaha, Christchurch, New Zealand.
Benyamin GrosmanMedtronic Inc, Northeast Minneapolis, 710 Medtronic Parkway, Minneapolis, MN, USA.
Jonathan WillimanDepartment of Paediatrics, Te Whatu Ora Waitaha, Christchurch, New Zealand.
Natalie KurtzMedtronic Inc, Northeast Minneapolis, 710 Medtronic Parkway, Minneapolis, MN, USA.
Vanessa GuzmanMedtronic Inc, Northeast Minneapolis, 710 Medtronic Parkway, Minneapolis, MN, USA.
Andrea BenedettiMedtronic Inc, Northeast Minneapolis, 710 Medtronic Parkway, Minneapolis, MN, USA.
Anirban RoyMedtronic Inc, Northeast Minneapolis, 710 Medtronic Parkway, Minneapolis, MN, USA.
Kamuran TurksoyMedtronic Inc, Northeast Minneapolis, 710 Medtronic Parkway, Minneapolis, MN, USA.
Magaly JuarezMedtronic Inc, Northeast Minneapolis, 710 Medtronic Parkway, Minneapolis, MN, USA.
Shirley JonesDepartment of Women's and Children's Health, Dunedin School of Medicine, University of Otago, 201 Great King St, Dunedin, Otago, 9016, New Zealand.
Carla FrewenDepartment of Women's and Children's Health, Dunedin School of Medicine, University of Otago, 201 Great King St, Dunedin, Otago, 9016, New Zealand.
Antony WatsonDepartment of Paediatrics, Te Whatu Ora Waitaha, Christchurch, New Zealand.
Barry TaylorDepartment of Women's and Children's Health, Dunedin School of Medicine, University of Otago, 201 Great King St, Dunedin, Otago, 9016, New Zealand.
Benjamin J WheelerDepartment of Women's and Children's Health, Dunedin School of Medicine, University of Otago, 201 Great King St, Dunedin, Otago, 9016, New Zealand. ben.wheeler@otago.ac.nz.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMultiple clinician adjustable parameters impact upon glycemia in people with type 1 diabetes (T1D) using Medtronic Mini Med 780G (MM780G) AHCL. These include glucose targets, carbohydrate ratios (CR), and active insulin time (AIT). Algorithm-based decision support advising upon potential settings adjustments may enhance clinical decision-making.

methodsSingle-arm, two-phase exploratory study developing decision support to commence and sustain AHCL. Participants commenced investigational MM780G, then 8 weeks Phase 1-initial optimization tool evaluation, involving algorithm-based decision support with weekly AIT and CR recommendations. Clinicians approved or rejected CR and AIT recommendations based on perceived safety per protocol. Co-design resulted in a refined algorithm evaluated in a further identically configured Phase 2. Phase 2 participants also transitioned to commercial MM780G following "Quick Start" (algorithm-derived tool determining initial AHCL settings using daily insulin dose and weight). We assessed efficacy, safety, and acceptability of decision support using glycemic metrics, and the proportion of accepted CR and AIT settings per phase.

resultsFifty three participants commenced Phase 1 (mean age 24.4; Hba1c 61.5mmol/7.7%). The proportion of CR and AIT accepted by clinicians increased between Phases 1 and 2 respectively: CR 89.2% vs. 98.6%, p < 0.01; AIT 95.2% vs. 99.3%, p < 0.01. Between Phases, mean glucose percentage time < 3.9mmol (< 70mg/dl) reduced (2.1% vs. 1.4%, p = 0.04); change in mean TIR 3.9-10mmol/L (70-180mg/dl) was not statistically significant: 72.9% ± 7.8 and 73.5% ± 8.6. Quick start resulted in stable TIR, and glycemic metrics compared to international guidelines.

conclusionThe co-designed decision support tools were able to deliver safe and effective therapy. They can potentially reduce the burden of diabetes management related decision making for both health care practitioners and patients.

trial registrationProspectively registered with Australia/New Zealand Clinical Trials Registry(ANZCTR) on 30th March 2021 as study ACTRN12621000360819.

Indexed as

Blood GlucoseDiabetes Mellitus, Type 1Hypoglycemic AgentsInsulinInsulin Infusion SystemsAdolescentAdultAlgorithmsDecision Support Systems, ClinicalDecision Support TechniquesFemaleFollow-Up StudiesGlycated HemoglobinHumansMaleYoung AdultBlood GlucoseGlycated HemoglobinHypoglycemic AgentsInsulinClosed loop devicesContinuous glucose monitoringDecision support toolsGlycemiaType 1 diabetes

Identifiers

PMID39215272
PMCPMC11363409

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.