Comparison of MiniMed 780G system performance in users aged younger and older than 15 years: Evidence from 12 870 real‐world users

Abstract

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.

Predictors of time in target glucose range in real‐world users of the MiniMed 780G system

“…Data obtained from 12 870 users of the MiniMed 780G system are consistent with previous real-world analyses, 1 smaller cohorts and clinical studies 4,15,16 and thus provide further evidence relating to the robust nature of the outcomes achieved with the 780G system. The robustness of the results across different countries and age groups (reported by Arrieta et al 17 ), combined with the sustained results beyond the initial interest in a new device, attest to the nature of the therapy, which is less dependent on users and their health care professionals (HCPs) and relies more on device automation. The decreasing role of users and HCPs, in terms of glycaemic control, is not trivial and was apparent from the first steps of automation, when insulin suspension before low glucose algorithms were adopted to minimize hypoglycaemia.…”

“…In screening variables for statistical associations with higher TIR, several demographic factors were noted as important; increase in age was associated with a 2.5 percentage points increase in TIR for users aged >55 years versus those aged ≤15 years, and male users had on average 0.9% higher TIR relative to female users. Although the changes were statistically significant, the overall outcomes across all ages and genders were well within the recommended guidelines 8 and the traditional gap in control in the younger versus older population 11,19 is diminished with the AHCL system 17 . The use of technology in older age groups has been associated with good glycaemic control 20‐22 .…”

“…Although the changes were statistically significant, the overall outcomes across all ages and genders were well within the recommended guidelines 8 and the traditional gap in control in the younger versus older population 11,19 is diminished with the AHCL system. 17 The use of technology in older age groups has been associated with good glycaemic control. [20][21][22] It is, therefore, not surprising that automated systems that require less operator input provide for better glycaemic control in the older population with the associated more sedentary and structured lifestyle.…”

“…Therefore, based on the analysis performed, the recommended setting for AIT is 2 h. The recommended target of 100 mg/dl is also proposed for the majority of users, while a target of 110 mg/dl is recommended in the following situations: (a) age <15 years; 17 (b) when concerned about exacerbation of retinopathy when glucose levels are reduced rapidly (may use target of 120 mg/dl) 26 ; and (c) presence of hypoglycaemia anxiety and when symptoms occur. 27 Figure 2 shows the incremental effect on glycaemic control induced by the different parameters and its comparison with the allusers' cohort.…”

Body mass index, basal insulin and glycemic control in children with type 1 diabetes treated with the advanced hybrid closed loop system remain stable - 1-year prospective, observational, two-center study

“…We describe stable BMI z-scores of children and adolescents with T1D using the AHCL system during a 1-year follow up which is the first such long observation (34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45). Similar results, also for a pediatric cohort of individuals with T1D, were obtained by Tornese et al, who reported no change in BMI zscore after 6 months of insulin treatment using either the hybrid closed-loop (Minimed 670G) or AHCL (Minimed 780G) systems.…”