Successful Initiation of Hybrid Closed-Loop System Using Virtual Pump Training Program in a Teenager With Type 1 Diabetes Previously Treated with Multiple Daily Injections

Due to the coronavirus disease 2019 restrictions in providing diabetes services, we have developed an innovative pump training program, which consisted of technical session, pump training, one in-person practical session, and four consecutive online sessions (Skype Meet Now). A 13-year-old female patient with a 4-year history of type 1 diabetes (T1D) on multiple daily injections (MDI) with glycated hemoglobin 8.9%; 74 mmol/mol) initiated Minimed 670G system using the program. Time in range (70-180 mg/dL) of 39% and sensor glucose (SG) of 214±91 mg/dL (MDI with continuous glucose monitoring) increased to 69% in the first 2 weeks and reached 86% and SG of 140±40 mg/dL in the first month of auto mode initiation, without severe hypoglycemia or hyperglycemia. Virtual pump training program can be an effective tool to initiate a hybrid closed-loop system and to improve glycemic control in people with T1D on MDI.