Safety, metabolic and psychological outcomes of Medtronic MiniMed 670G in children, adolescents and young adults: a systematic review

Mameli, Chiara; Smylie, Giulia Marie; Galati, Alessio; Rapone, Biagio; Cardona-Hernández, Roque; Zuccotti, Gian Vincenzo; Delvecchio, Maurizio

doi:10.1007/s00431-023-04833-4

Cited by 9 publications

(5 citation statements)

References 52 publications

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“…Although there was no difference in hypoglycemia time, the use of an HCL system was related to a decrease in HbA1c level and a greater number of patients who reached the HbA1c target level of < 7%. These findings are in line with previous systematic reviews that demonstrated the safety of different HCL devices without increased risk of hypoglycemia ( 21 , 22 ).…”

Section: Discussionsupporting

confidence: 92%

“…Previous systematic reviews and meta-analyses including both adults and children have shown efficacy and safety of HCL over control therapies ( 18 – 20 ). However, these studies presented combined outcomes from children and adults, since analyses specifically focused on children were unfeasible ( 21 , 22 ). Thus, the aim of this study was to perform a systematic review and meta-analysis of RCTs to evaluate the efficacy and safety of HCL treatment in children and adolescents with T1D.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of the hybrid closed-loop insulin delivery system in children and adolescents with type 1 diabetes: a meta-analysis with trial sequential analysis

Ferreira,

Trevisan,

Pasqualotto

et al. 2024

Archives of Endocrinology and Metabolism

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The aim of this study was to assess the efficacy and safety of hybrid closed-loop (HCL) systems for insulin delivery in children and adolescents with type 1 diabetes (T1D). We searched Embase, PubMed, and Cochrane Library for randomized controlled trials (RCTs) published until March 2023 comparing the HCL therapy with control therapies for children and adolescents with T1D. We computed weighted mean differences (WMDs) for continuous outcomes and risk ratios (RRs) with 95% confidence intervals (CIs) for binary endpoints. Four RCTs and 501 patients were included, of whom 323 were randomized to HCL therapy. Compared with control therapies, HCL significantly improved the period during which glucose level was 70-180 mg/dL (WMD 10.89%, 95% CI 8.22-13.56%) and the number of participants with glycated hemoglobin (HbA1c) level < 7% (RR 2.61, 95% CI 1.29-5.28). Also, HCL significantly reduced the time during which glucose level was > 180 mg/dL (WMD -10.46%, 95% CI -13.99 to -6.93%) and the mean levels of glucose (WMD -16.67 mg/dL, 95% CI -22.25 to -11.09 mg/ dL) and HbA1c (WMD -0.50%, 95% CI -0.68 to -0.31). There were no significant differences between therapies regarding time during which glucose level was < 70 mg/dL or <54 mg/dL or number of episodes of ketoacidosis, hyperglycemia, and hypoglycemia. In this meta-analysis, HCL compared with control therapies was associated with improved time in range and HbA1c control in children and adolescents with T1D and a similar profile of side effects. These findings support the efficacy of HCL in the treatment of T1D in this population.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Efficacy of the hybrid closed-loop insulin delivery system in children and adolescents with type 1 diabetes: a meta-analysis with trial sequential analysis

Ferreira,

Trevisan,

Pasqualotto

et al. 2024

Archives of Endocrinology and Metabolism

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“…The previous generation of AID systems provided some benefits for users, but the frequent auto mode exits and user-input requirements presented a significant burden. The result was that the previous AID system was not effective regarding the improvement of psychosocial outcomes [ 11 ]. However, treatment satisfaction was significantly improved compared with that achieved with SAP + PLGM use [ 40 ] and MDI therapy [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…It implements a modified proportional–integral–derivative (PID) algorithm that automatically adjusts the basal insulin delivery rate to achieve a predetermined sensor glucose target of 120 mg/dL. Data from clinical trials and observational studies have shown an overall beneficial effect on glycaemic outcomes among paediatric and adult participants [ 11 ]. However, the need for more aggressive and efficient AID systems has arisen from the difficulty of maintaining sustained optimal glycaemic outcomes for many users [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Safety, Metabolic and Psychological Outcomes of Medtronic MiniMed 780G™ in Children, Adolescents and Young Adults: A Systematic Review

Passanisi,

Lombardo,

Mameli

et al. 2023

Diabetes Ther

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The MiniMed™ 780G is a second-generation automated insulin delivery system that implements a modified proportional–integral–derivative algorithm with some features of an MD-Logic artificial pancreas algorithm. The system may deliver automatic correction boluses up to every 5 min, and it allows the user to choose between three glucose target setpoints (100, 110 and 120 mg/dL). We aimed to review the current evidence on this device in children, adolescents, and young adults living with type 1 diabetes. We screened 783 papers, but only 31 manuscripts were included in this review. Data on metabolic outcomes show that this system is safe as regards severe hypoglycaemia and diabetic ketoacidosis. The glycated haemoglobin may drop to levels about 7%, with CGM reports showing a time in range of 75–80%. The time above range and the time below range are within the recommended target in most of the subjects. Few studies evaluated the psychological outcomes. This system seems to be more effective than the first-generation automated insulin delivery systems. The MiniMed™ 780G has been associated with an improvement in sleep quality in subjects living with diabetes and their caregivers, along with an improvement in treatment satisfaction. Psychological distress is as reduced as the glucose control is improved. We also discuss some case reports describing particular situations in clinical practice. Finally, we think that data show that this system is a further step towards the improvement of the treatment of diabetes as concerns both metabolic and psychological outcomes.

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“…We would like to end this Editorial by focusing the readers’ attention on relevant data for clinical practice. Over the last 5 years, we passed from the HCL system (MiniMed 670G ® ), which allowed a TIR of approximately 65 to 70% and a TBR below 4% ( 9 ), to the new AHCL systems which allow a TIR of approximately 75% and a further reduction in TBR ( 10 , 11 ). Blood glucose control improves as fast as technologies for diabetes go on.…”

mentioning

confidence: 99%

Editorial: Technologies for diabetes

et al. 2023

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Safety, metabolic and psychological outcomes of Medtronic MiniMed 670G in children, adolescents and young adults: a systematic review

Cited by 9 publications

References 52 publications

Efficacy of the hybrid closed-loop insulin delivery system in children and adolescents with type 1 diabetes: a meta-analysis with trial sequential analysis

Efficacy of the hybrid closed-loop insulin delivery system in children and adolescents with type 1 diabetes: a meta-analysis with trial sequential analysis

Safety, Metabolic and Psychological Outcomes of Medtronic MiniMed 780G™ in Children, Adolescents and Young Adults: A Systematic Review

Editorial: Technologies for diabetes

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