Rapid Improvement in Time in Range After the Implementation of an Advanced Hybrid Closed-Loop System in Adolescents and Adults with Type 1 Diabetes

Area of Science:

• Endocrinology
• Biomedical Engineering

Background:

• Advanced hybrid closed-loop (AHCL) systems represent a significant advancement in automated insulin delivery for type 1 diabetes (T1D).
• The MiniMed 780G system offers adjustable glucose targets and autocorrection boluses to optimize glycemic control.

Purpose of the Study:

• To prospectively evaluate the clinical impact of implementing the MiniMed 780G AHCL system.
• To assess changes in glucose control metrics after upgrading from sensor-augmented pump with predictive low-glucose suspend (SAP-PLGS) to AHCL.

Main Methods:

• Fifty-two T1D subjects were upgraded to the AHCL system.
• Sensor and pump data were collected at baseline, every 3 days, 2 weeks, and 1 month.
• Glucose target was set to 100 mg/dL and active insulin time to 2 hours for all participants.

Main Results:

• Time in range (70-180 mg/dL) significantly increased from 67.3% to 79.6% (P=0.001) within 1 month.
• Time in hyperglycemia (>180 mg/dL and >250 mg/dL) decreased significantly (P=0.001).
• No significant increase in hypoglycemia (<70 mg/dL or <54 mg/dL) was observed; Time in Auto Mode was 97%.

Conclusions:

• AHCL systems, particularly with aggressive settings, enable rapid improvements in time in range for well-controlled T1D patients.
• The MiniMed 780G system provides effective glycemic management without increasing hypoglycemia frequency.