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

Abstract

Aim: Automated insulin delivery systems have improved glycaemic control in people with type 1 diabetes mellitus. The analysis investigated predictors of improved sensor glucose time-in-range (TIR; 70-180 mg/dl) based on real-world use of the MiniMed 780G advanced hybrid closed-loop (AHCL) system.Methods: Data uploaded by MiniMed 780G system users from August 2020-July 2021 were analysed using univariate and multivariable models to identify baseline, demographic and system use characteristics associated with TIR after AHCL initiation (post-AHCL). System settings associated with improved TIR post-AHCL were identified and their impact on time below range (TBR, <70 mg/dl) post-AHCL was explored.Results: In total, 12 870 users were included, of which 2977 had baseline sensor glucose data. Baseline TIR and time in AHCL (defined as the percentage of time the system was in Auto-mode) were positively associated with TIR post-AHCL with larger values predicting greater mean TIR post-AHCL. Characteristics inversely associated with TIR post-AHCL included the percentage of daily basal insulin dose, daily autocorrection dose, number of daily AHCL exits triggered by the system and number of daily alarms, wherein larger values of these characteristics predicted lower mean TIR post-AHCL. System settings that predicted the largest mean TIR post-AHCL were active insulin time of 2 h and glucose target of 100 mg/dl. Active insulin time was not associated with TBR post-AHCL. Conclusion:Modifiable factors, including optimized pump settings, can allow users to achieve glycaemic targets with >80% TIR. The findings from this analysis will potentially guide the optimal use of the MiniMed 780G system and facilitate meaningful improvements in safe glycaemic control.

Real‐world performance of the MiniMed 780G advanced hybrid closed loop system in Latin America: Substantial improvement in glycaemic control with each technology iteration of the MiniMed automated insulin delivery system

“…The MiniMed 780G system has been shown to achieve safely the internationally recommended glycaemic targets, both in clinical trials as in real-world analyses. [4][5][6][7] Currently, there are large disparities in racial, ethnic and regional representation in clinical studies as well as in real-world studies on the use and outcomes of technology in T1D. 8,9 Inclusive studies may boost the acceptability of and the access to medical devices by historically excluded populations and geographies, and they may identify differences in outcomes between various groups.…”

“…Several real-world studies on MiniMed 780G system have been published to date, 6,7,10 and the most recent one has shown 12 870 mainly European MiniMed 780G users to achieve a mean time in range (TIR) of 75.8%, a mean time below range of 70 mg/dl (TBR) of 2.5% and a mean glucose management indicator (GMI) of 6.8%. 6 As these studies do not contain data on a previous treatment modality, studying the contribution of increased automation per se was not possible. We were able to identify a cohort of Latin American real-world users of the MiniMed 780G system that have transitioned to a new MiniMed system with each iteration of technology.…”

“…When encompassing large and unbiased populations, they can complement the data generated from clinical trials (that mostly include rather homogeneous populations and controlled environments). Several real-world studies on MiniMed 780G system have been published to date, 6,7,10 and the most recent one has shown 12 870 mainly European MiniMed 780G users to achieve a mean time in range (TIR) of 75.8%, a mean time below range of 70 mg/dl (TBR) of 2.5% and a mean glucose management indicator (GMI) of 6.8%. 6 As these studies do not contain data on a previous treatment modality, studying the contribution of increased automation per se was not possible.…”

“…The MiniMed (MM) 780G system, one of the most recent AID systems in the field, includes an advanced hybrid closed loop (AHCL) algorithm that automatically delivers basal insulin and autocorrection boluses every 5 min (as needed) aiming a predefined glucose target (GT). The MiniMed 780G system has been shown to achieve safely the internationally recommended glycaemic targets, both in clinical trials as in real‐world analyses 4‐7 …”

Automated Insulin Delivery (AID) Systems: Use and Efficacy in Children and Adults with Type 1 Diabetes and Other Forms of Diabetes in Europe in Early 2023

“…Specific features of MiniMed 780G, that differentiate it from other AHCL systems are the customizable blood glucose target at 100, 110 or 120 mg/dL and active insulin time (AIT) customizable from 2 to 8 h [ 19 ]. In addition, it is possible to activate a temporary target function at 150 mg/dL, which can be useful in situations where a smaller amount of insulin is needed, such as during physical activity; no automatic correction boluses are delivered in this mode.…”