{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T12:16:08Z","timestamp":1783685768113,"version":"3.55.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004505","name":"Universit\u00e0 degli Studi di Catania","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004505","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Endocrine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Unannounced meals pose a major challenge to type 1 diabetes patients. This study compared the performance of two automated insulin delivery (AID) algorithms, the Medtronic MiniMed 780G\u2019s proportional-integral-derivative (PID) and the Tandem t: slim X2\u2019s model predictive control (MPC), following unannounced breakfasts (ClinicalTrials.gov identifier: NCT07455643, retrospectively registered the 3rd of February 2026).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a randomized crossover study, we enrolled 20 children between 11 and 18 years using the MiniMed 780G or the Tandem t: slim X2 AID system. Endpoints included 2-hour and 4-hour blood glucose difference (\u0394BG), glucose peak, time to peak, and time spent above (TAR), below (TBS), in range (TIR), and in tight range (TITR). Two meals were tested: a carbohydrate (CHO) meal and a mixed one, both containing 30\u00a0g of carbohydrates, and additional 15\u00a0g proteins for the mixed meal. Announced (AM) and unannounced (UM) meals were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>AM, compared to UM, showed significant higher 2-hour\u0394BG; conversely 4-hour\u0394BG did not differ significantly. In CHO AM, algorithms were comparable. In mixed AM, PID gained lower peaks and TAR, with higher TIR and TITR. In UM, PID obtained lower 2-hour\u0394BG than MPC, with reduced peak, TAR, and improved TIR and TITR. Differences in 4-hour\u0394BG and time-at-peak were not significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both AID algorithms mitigated postprandial glycemia and returned glucose to baseline levels within 4\u00a0h without safety concerns. The PID demonstrated higher reactivity to unannounced meals, while performances were comparable when meal boluses were properly announced.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>ClinicalTrials.gov identifier<\/jats:title>\n                    <jats:p>NCT07455643.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12020-026-04705-5","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:24:38Z","timestamp":1783682678000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The CRUMB study: closed-loop response to unannounced mixed and carbohydrates-rich breakfasts. A randomized controlled crossover pilot-study in a cohort of adolescents with type 1 diabetes"],"prefix":"10.1007","volume":"91","author":[{"given":"Donatella","family":"Lo Presti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2194-4792","authenticated-orcid":false,"given":"Salvatore","family":"Scir\u00e8 Calabrisotto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2199-4310","authenticated-orcid":false,"given":"Letizia Grazia","family":"Tomaselli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8832-2902","authenticated-orcid":false,"given":"Giulia","family":"Pezzino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5556-3201","authenticated-orcid":false,"given":"Francesco","family":"Frasca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0524-4525","authenticated-orcid":false,"given":"Roberto","family":"Baratta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3258-7200","authenticated-orcid":false,"given":"Laura","family":"Sciacca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Concetta","family":"Latina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1338-052X","authenticated-orcid":false,"given":"Nadia","family":"La Spina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4104-1105","authenticated-orcid":false,"given":"Francesco","family":"Galeano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5210-8601","authenticated-orcid":false,"given":"Vittorio","family":"Oteri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5820-4178","authenticated-orcid":false,"given":"Andrea","family":"Tumminia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"4705_CR1","doi-asserted-by":"publisher","first-page":"110678","DOI":"10.1016\/j.diabres.2023.110678","volume":"199","author":"P Michou","year":"2023","unstructured":"P. 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The study protocol was formally submitted to the National Pediatric Ethics Committee for regulatory oversight and approval. Then, to ensure maximal transparency and public accountability, the trial was registered at ClinicalTrials.gov (Identifier: NCT07455643, retrospectively registered the 3rd of February 2026), adhering to international standards for clinical research reporting.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Written informed consent was obtained from the parents of all the individual participants included in the study, including permission to publish the results in an anonymous aggregated fashion.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate and to publish"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}}],"article-number":"222"}}