Background: The MiniMed™ 780G system includes an Advanced Hybrid Closed Loop (AHCL) algorithm which provides for both automated basal and correction bolus insulin delivery. The preliminary performance of the system in real-world settings was evaluated.Methods: Data uploaded from August 2020 to March 2021 by individuals living in Belgium,
Aim
To investigate real‐world glycaemic outcomes and goals achieved by users of the MiniMed 780G advanced hybrid closed loop (AHCL) system aged younger and older than 15 years with type 1 diabetes (T1D).
Materials and Methods
Data uploaded by MiniMed 780G system users from 27 August 2020 to 22 July 2021 were aggregated and retrospectively analysed based on self‐reported age (≤15 years and >15 years) for three cohorts: (a) post‐AHCL initiation, (b) 6‐month longitudinal post‐AHCL initiation and (c) pre‐ versus post‐AHCL initiation. Analyses included mean percentage of time spent in AHCL and at sensor glucose ranges, insulin delivered and the proportion of users achieving recommended glucose management indicator (GMI < 7.0%) and time in target range (TIR 70‐180 mg/dl > 70%) goals.
Results
Users aged 15 years or younger (N = 3211) achieved a GMI of 6.8% ± 0.3% and TIR of 73.9% ± 8.7%, while spending 92.7% of time in AHCL. Users aged older than 15 years (N = 8874) achieved a GMI of 6.8% ± 0.4% and TIR of 76.5% ± 9.4% with 92.3% of time in AHCL. Time spent at less than 70 mg/dl was within the recommended target of less than 4% (3.2% and 2.3%, respectively). Similar outcomes were observed for each group (N = 790 and N = 1642, respectively) in the first month following AHCL initiation, and were sustained over the 6‐month observation period.
Conclusions
This real‐world analysis shows that more than 75% of users with T1D aged 15 years or younger using the MiniMed 780G system achieved international consensus‐recommended glycaemic control, mirroring the achievements of the population aged older than 15 years.
Aim: To evaluate the real-world performance of the MiniMed 670G system in Europe, in individuals with diabetes.Materials and Methods: Data uploaded from October 2018 to July 2020 by individuals living in Europe were aggregated and retrospectively analysed. The mean glucose management indicator (GMI), percentage of time spent within (TIR), below (TBR) and above (TAR) glycaemic ranges, system use and insulin consumed in users with 10 or more days of sensor glucose data after initial Auto Mode start were determined. Another analysis based on suboptimally (GMI > 8.0%) and well-controlled (GMI < 7.0%) glycaemia pre-Auto Mode initiation was also performed.Results: Users (N = 14 899) spent a mean of 81.4% of the time in Auto Mode and achieved a mean GMI of 7.0% ± 0.4%, TIR of 72.0% ± 9.7%, TBR less than 3.9 mmol/L of 2.4% ± 2.1% and TAR more than 10 mmol/L of 25.7% ± 10%, after initiating Auto Mode. When compared with pre-Auto Mode initiation, GMI was reduced by 0.3% ± 0.4% and TIR increased by 9.6% ± 9.9% (P < .0001 for both). Significantly improved glycaemic control was observed irrespective of pre-Auto Mode GMI levels of less than 7.0% or of more than 8.0%. While the total daily dose of insulin increased for both groups, a greater increase was observed in the latter, an increase primarily due to increased basal insulin delivery. By contrast, basal insulin decreased slightly in well-controlled users.Conclusions: Most MiniMed 670G system users in Europe achieved TIR more than 70% and GMI less than 7% while minimizing hypoglycaemia, in a real-world environment. These international consensus-met outcomes were enabled by automated insulin delivery meeting real-time insulin requirements adapted to each individual user.
OBJECTIVE
The aim of this study was to evaluate the outcomes of transitioning to the MiniMed 780G advanced hybrid closed loop (AHCL) system in adult individuals with type 1 diabetes mellitus (T1DM) naïve to continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) technologies.
RESEARCH DESIGN AND METHODS
This was a two-center, randomized, controlled, parallel-group trial with evaluation of individuals with T1DM aged 26–60 years managed with multiple daily injections (MDI) and self-monitoring of blood glucose (BGM) with HbA1c <10%.
RESULTS
A total of 41 participants were recruited and randomized to either the AHCL (n = 20) or the MDI+BGM (n = 21) group, and 37 participants (mean ± SD age 40.3 ± 8.0 years, duration of diabetes 17.3 ± 12.1 years, BMI 25.1 ± 3.1 kg/m2, HbA1c 7.2 ± 1.0%) completed the study. Time spent with glucose levels in target range increased from 69.3 ± 12.3% at baseline to 85.0 ± 6.3% at 3 months in the AHCL group, while remaining unchanged in the control group: treatment effect 21.5% (95% CI 15.7, 27.3); P < 0.001. The time with levels below range (<70 mg/dL) decreased from 8.7 ± 7.3% to 2.1 ± 1.7 in the AHCL group and remained unchanged in the MDI+BGM group (treatment effect −4.4% [95% CI −7.4, −2.1]; P < 0.001). Participants from the AHCL group also had significant improvements in HbA1c levels (treatment effect −0.6% [95% CI −0.9, −0.2]; P = 0.005) and in quality of life (QoL) in specific subscales compared with the MDI+BGM group.
CONCLUSIONS
People with T1DM naïve to CSII and CGM technologies initiating AHCL significantly and safely improved their glycemic control, as well as their QoL and psychological well-being.
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