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

Abstract

Aim We studied real‐world performance of MiniMed (MM) 780G system users from Argentina, Brazil, Colombia and Chile (geographical analysis), and the effect of each technology iteration of the MM system on glycaemic control (technology iteration analysis). Materials and Methods CareLink data from August 2020 to September 2022 were extracted. Endpoints included continuous glucose monitoring metrics. For the geographical analysis, aggregated endpoints for MM780G system users were calculated. For the technology iteration analysis, MM780G system user outcomes were compared with outcomes when the same individuals were still using the MM640G or MM670G system. Results On average, 1025 MM780G system users from the geographical analysis were followed for 136 (SD 135) days, spent 91.5 (14.3)% in advanced hybrid closed loop, showed a glucose management indicator (GMI) of 6.7 (0.3)%, a time in range between 70 and 180 mg/dl (TIR) of 76.5 (9.0)%, and a time below range 70 mg/dl (TBR) of 2.7 (2.1)%. The percentage of users reaching targets of GMI <7%, TIR >70% and TBR <4% was 80.8%, 78.1% and 80.1%, respectively. The technology iteration analysis on users transitioning from MM640G to MM780G system (N = 381) showed 0.4% decrease in GMI (7.1% to 6.7%, p < .0001), 10.7% increase in TIR (65.9% to 76.6%, p < .0001), while TBR remained. The percentage of insulin delivered automatically increased as well (47.5%‐57.7%, p < .0001). Users transitioning from MM670G system (N = 78) showed a similar but less pronounced pattern. Conclusions Real‐world Latin American MM780G users on average showed good glucose control, achieving international targets. Glycaemic control increased with every technology iteration of the MM system, providing more automation each time.

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

“…This AID system improves TIR compared to baseline by at least 10% after 4 weeks without any increase in TBR [ 15 , 29 , 38 ], and this finding has also been reported by other studies with longer follow-up periods of up to 1 year [ 30 , 31 , 34 , 36 , 39 ], which demonstrated a more remarkable improvement in TIR of up to 22% [ 35 , 37 ] without any significant change in BMI z -score [ 39 ]. Basically, the MiniMed™ 780G system allows a TIR of 75–80% to be reached [ 32 , 33 ]. It is worth noting that in all these studies, people with diabetes used rapid-acting insulin.…”

“…14 days, 3 months and 6 months) [ 31 ]. An analysis investigating the real-world performance of the MiniMed™ 780G system in 332 users from Latin America who were younger than 15 years of age revealed the following CGM outcomes: TIR 74.2 ± 8.9%, TAR 23 ± 9.0%, TAR2 5.2 ± 4.4%, TBR 2.9 ± 2.0%, TBR2 0.6 ± 0.7%, CV 35.9 ± 5.0%, mean SG 146.5 ± 14.1 mg/dL, SD 52.9 ± 10.7 mg/dL, and GMI 6.8 ± 0.3% [ 32 ]. Another retrospective study evaluating the raw data for 4193 patient-days of 34 children using the AHCL system reported the following results for glucose control indicators: HbA1c 7.1 ± 0.9%, TIR 80.5 ± 7.8%, TAR1 14.5 ± 6.2%, TAR2 2.5 ± 2.2%, TBR1 2 ± 1.5%, TBR2 0.5 ± 0.8%, CV 33.1%, mean SG 136.7 ± 11.6 mg/dL, SD of mean glucose 45.5 mg/dL, and GMI 6.6%.…”

How can we reach the target of glucose control in type 1 diabetes?

“…A registry of 46 043 people with T1D aged <1 to <26 years from 416 diabetes centers in Germany, Austria, Luxemburg, and Switzerland reported an increase in sensor‐augmented pump plus AID use from 32% in 2018 to 50% in 2021, with AID use increasing from 4% to 17%, and with improvement in time in range by 3% in those below age 6 years and by 5% in those age 6–26 years, in association with significant improvement in HbA1c in those age 11–26 years 26 . For 1025 people with T1D from Argentina, Brazil, Chile, or Colombia who had transitioned from insulin pump with sensor to a closed‐loop system, mean sensor glucose was 144 mg/dL with coefficient of variation (the standard deviation divided by the mean) 34% and GMI 6.7% 27 …”

“…26 For 1025 people with T1D from Argentina, Brazil, Chile, or Colombia who had transitioned from insulin pump with sensor to a closed-loop system, mean sensor glucose was 144 mg/dL with coefficient of variation (the standard deviation divided by the mean) 34% and GMI 6.7%. 27 The past 5 decades have witnessed dramatic improvement in the treatment of T1D. Studies from Finland show 30-year mortality around 50% for those developing diabetes in 1964-1971, around 40% for diabetes developing in 1972-1979, and around 15% for diabetes developing in the 1980s, with limited data suggesting even greater improvement for those developing diabetes after 1990.…”

“… 26 For 1025 people with T1D from Argentina, Brazil, Chile, or Colombia who had transitioned from insulin pump with sensor to a closed‐loop system, mean sensor glucose was 144 mg/dL with coefficient of variation (the standard deviation divided by the mean) 34% and GMI 6.7%. 27 …”