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.

Keywords: adolescents; automated insulin delivery; closed-loop system; diabetes; glucose management indicator; hyperglycaemia; hypoglycaemia; paediatric; real-world evidence; time in range.

Conflict of interest statement

TB served on advisory boards of Novo Nordisk, Sanofi, Eli Lilly, Boehringer, Medtronic, Indigo and DreaMed Diabetes; received honoraria for participating on the speaker's bureaux of Eli Lilly, Novo Nordisk, Medtronic, Abbott, Sanofi, Aventis, Astra Zeneca and Roche; and owns stock from DreamMed Diabetes. TB's institution received research grant support and TB received travel and accommodation expenses in some cases, from Abbott, Medtronic, Novo Nordisk, GluSense, Sanofi, Sandoz and Zealand Pharma. TB was funded, in part, by the Slovenian Research Agency grant #P3‐0343. AES has served on the advisory board for Medtronic, Movi and Harmonium; received honoraria for participating on the speaker's bureau of Sanofi, Abbott and Lilly; and has spoken for Medtronic without receiving a fee. AES's institution received research grant support and AES received travel and accommodation expenses in some cases for attending the meetings of Lilly, Movi and Medtronic. AA, JDS, TLC, JC, JS and OC are employees of Medtronic.

© 2022 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

Figures

FIGURE 1

MiniMed 780G system performance post‐AHCL initiation (cohort 1). Values are shown as mean or mean ± standard deviation. For the specified glucose target and AIT settings, individuals used both for ≥90% of the time. AHCL, advanced hybrid closed‐loop; AIT, active insulin time; CV, coefficient of variation; GMI, glucose management indicator; SG, sensor glucose

FIGURE 2

Percentage of users achieving treatment goals with the MiniMed 780G system and optimized settings (cohort 1). The percentage of real‐world users aged A, 15 years or younger, and B, Older than 15 years achieving each treatment goal (GMI of <7%, TIR of >70% and TBR70 of <4%) and a combination of the treatment goals are shown when the 100 mg/dl (5.6 mmol/L) or 110 mg/dl (6.1 mmol/L) glucose target was used with the 2 hours AIT setting. Analyses are based on individuals who used the specified glucose target and AIT setting 90% or more of the time. AIT, active insulin time; GMI, glucose management indicator; TBR70, time below range (<70 mg/dl [<3.9 mmol/L]); TIR, time in range (70‐80 mg/dl [3.9‐18 mmol/L])

FIGURE 3

Performance of the MiniMed 780G system over 6 months (cohort 2). The total daily dose of insulin, percentage of time in AHCL and glycaemic outcomes are shown for users aged A, 15 years or younger, and B, Older than 15 years who had 10 or more days of SG data in each of the 6 months following AHCL initiation. AHCL, advanced hybrid closed loop; GMI, glucose management indicator; SG, sensor glucose; TDD, total daily dose

FIGURE 4

MiniMed 780G system performance pre‐ and post‐AHCL initiation (cohort 3). The glycaemic outcomes and proportion of users achieving treatment goals (GMI of <7.0% and TIR of >70%) are shown for those aged 15 years or younger and older than 15 years who had at least 10 days of SG data pre‐ and post‐AHCL initiation. The asterisk (*) indicates P < .001 for the comparison between pre‐AHCL initiation and post‐AHCL. AHCL, advanced hybrid closed loop; GMI, glucose management indicator; SG, sensor glucose; TIR, time in range