PID versus MPC Algorithm Response to Unannounced Meals in Adolescents

This crossover pilot compares the reactivity of two commercial automated insulin delivery algorithms to unannounced small carbohydrate and mixed meals, informing device-selection counseling for adolescents prone to missed boluses.

insulinautomated insulin deliveryMiniMed 780GTandem Control-IQPID algorithmMPC algorithmtype 1 diabetesadolescentsunannounced mealscontinuous glucose monitoringcrossover trialpediatric endocrinology Endocrinology / Obesity

Background Information

The PID algorithm optimizes glycemic control for unannounced meals in adolescents with type 1 diabetes.

Managing unannounced meals is a critical aspect of diabetes care for adolescents to prevent glycemic excursions. The proportional-integral-derivative (PID) algorithm showed better glucose control after unannounced meals, with lower two-hour blood glucose differences (ΔBG) compared to the model predictive control (MPC), without safety issues. While both algorithms are effective, the PID algorithm may provide superior glycemic control for unannounced carbohydrate-rich meals, highlighting its usefulness for adolescent patients with type 1 diabetes. The study's small size limits generalizability. PID algorithm excels in handling unannounced meals in type 1 diabetes.

📊 Deep Analysis Available

Subscribers get the full breakdown: study design, outcomes, pharmacist implications, clinical pearls, GRADE evidence grade, and a downloadable PDF report.

Subscribe for Full Access →

Authors: Lo Presti D, Scirè Calabrisotto S, Tomaselli LG, Pezzino G, Frasca F, Baratta R, Sciacca L, Latina C, La Spina N, Galeano F, Oteri V, Tumminia A

Citation: Lo Presti D, Scirè Calabrisotto S, Tomaselli LG, et al. 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. Endocrine. 2026;91(1). doi:10.1007/s12020-026-04705-5

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

🎓

Reviewed by a licensed pharmacist

Every analysis is reviewed and approved by a licensed pharmacist before publication, ensuring clinical accuracy and relevance.

Accurate and up-to-date information is our highest priority.

If you spot an error, please suggest a correction. If there is a topic you want covered, tell us and we will look at it.

Suggest a correction Request a topic

🔒

Deep Analysis: Subscribers Only

Subscribers receive access to a complete clinical analysis, available online and as a downloadable PDF.

Executive Summary

Study Design

Patient Population

Primary Outcomes

Secondary Outcomes & Safety Profile

Pharmacist Implications

Clinical Pearls

Limitations

Controversies & Evidence Gaps

Cost & Logistics

Want the full analysis?

Subscribe to PharmD Signal for unrestricted access to every deep analysis, plus PDF reports, GRADE evidence grades, and pharmacist implications for every article we publish.

Become a Subscriber →