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A Retrospective Real-Life Study to Compare Glycemic Control Between Simplified Meal Size Estimation and Precise
Julie Blervaque1, Aurélien Vésin2, Pierre-Yves Benhamou1
1Department of Endocrinology, Grenoble University Hospital, Grenoble Alpes University, Grenoble, France.
Diabetes Technology & Therapeutics
|September 25, 2025
Summary
Qualitative meal size estimation (QMSE) offers similar glycemic control to precise carbohydrate counting (PCC) for type 1 diabetes patients using hybrid closed-loop systems. This simpler method may reduce the burden of diabetes management.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Biomedical Engineering
Background:
- Hybrid closed-loop systems (HCL) for type 1 diabetes management require accurate carbohydrate intake data.
- Precise carbohydrate counting (PCC) can be burdensome for patients.
- Qualitative meal size estimation (QMSE) presents a potentially simpler alternative for meal declaration.
Purpose of the Study:
- To compare postprandial glycemic control between QMSE and PCC in patients using the DBLG1 HCL system.
- To evaluate the clinical relevance of any observed differences in glycemic metrics.
Main Methods:
- Retrospective analysis of 1959 type 1 diabetes patients using the DBLG1 system in Europe.
- Patients were categorized into QMSE and PCC groups based on meal declaration methods.
- Postprandial glucose metrics, including time in range (TIR) and time below range (TBR), were analyzed over 4-hour periods.
Main Results:
- Over 614,000 meals were analyzed, with 53% declared via QMSE and 47% via PCC.
- Postprandial time in range (TIR) was comparable: 62.39% ± 30.86% for QMSE vs. 63.21% ± 30.62% for PCC.
- Time below range (TBR < 70 mg/dL) was low and similar for both methods (1.4% ± 5.0% for QMSE, 1.4% ± 4.8% for PCC).
Conclusions:
- QMSE provides similar glycemic control outcomes to PCC in patients using the DBLG1 HCL system.
- QMSE is a viable alternative that may reduce the daily burden of diabetes management.
- This method can benefit patients who find PCC challenging or are reluctant to use it.
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