Improvement in Tight Glycemic Control in Adults with Type 1 Diabetes Using the MiniMed™ 780G Hybrid Closed-Loop...

Hybrid Closed-Loop (HCL) systems improve glycemic control in patients with Type 1 Diabetes Mellitus (T1D). An increasing body of evidence supports the utility of time within a tight range (TITR, 70-140 mg/dL) as a marker of near normoglycemia. The primary objective was to evaluate changes in TITR (70-140 mg/dL) at 3 months following initiation of the MiniMed™ 780G system in adults with T1D in routine clinical practice. Secondary objectives included: (i) assessment of changes in TIR, mean glucose, GMI, CV, TAR, TBR, and total daily insulin dose at 14 days and 3 months post-initiation; (ii) characterization of the temporal trajectory of glycemic improvement from baseline to 3 months; and (iii) an exploratory comparison of glycemic outcomes between patients previously treated with MDI and those previously treated with CSII.

This single-center, retrospective, consecutive cohort study included 23 adults with T1D who initiated the MiniMed™ 780G system between September and December 2024. Glycemic data were collected for 14 days before HCL initiation, the first 14 days after initiation, and at 3 months. The outcomes included TIR, TITR, GMI, glucose variability (CV), time above and below the range, and insulin requirements. Exploratory analyses compared the outcomes of patients previously administered multiple daily injections (MDI, n=4) and those receiving continuous subcutaneous insulin infusion (CSII, n=19).

At 3 months, TIR and TITR improved by 13.0% and 12.2%, respectively (both p<0.001). Mean glucose fell by 16.7 mg/dL, GMI by 0.38%, and CV by 3.41%. Time below range decreased despite a significant increase in total daily insulin dose (from 0.25 to 0.58 IU/kg, p<0.001). Improvements were achieved within the first 14 days and remained stable thereafter. Patients transitioning from MDI had poorer baseline glycemic control but showed greater relative improvements in this exploratory analysis; however, between-group differences were not statistically significant, given the exploratory nature of this analysis.

These results are consistent with previously published real-world evidence on the MiniMed™ 780G system and support TITR as a sensitive metric for capturing the benefits of advanced HCL therapy. The early onset and sustained nature of glycemic improvement, along with the absence of increased hypoglycemia, suggests that aggressive system settings may safely optimize glycemic outcomes in routine clinical practice. These findings should be interpreted in the context of the single-center design and limited sample size.

MiniMed™ 780G use was associated with early and sustained improvements in glycemic control, particularly in TITR, without increasing hypoglycemia. These findings support the effectiveness of this system for safely achieving near normoglycemia in real-world clinical practice.