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. 2024 Dec;15(12):2557-2568.
doi: 10.1007/s13300-024-01656-w. Epub 2024 Sep 30.

12-Month Time in Tight Range Improvement with Advanced Hybrid-Closed Loop System in Adults with Type 1 Diabetes

Laura Nigi  1   2 , Maria De Los Angeles Simon Batzibal  3 , Dorica Cataldo  4 , Francesco Dotta  3   4
Affiliations

12-Month Time in Tight Range Improvement with Advanced Hybrid-Closed Loop System in Adults with Type 1 Diabetes

Laura Nigi et al. Diabetes Ther. 2024 Dec.

Abstract

Introduction: Time in tight range (TITR) is an emerging and valuable metric for assessing normoglycemia. The latest advancement in automated insulin delivery (AID) systems, the advanced hybrid closed-loop (AHCL) systems, are particularly noteworthy for managing type 1 diabetes (T1D) and enhancing glycemic control.

Methods: In a real-world clinical setting, we carried out a retrospective evaluation of TITR in 42 adult subjects with T1D using the AHCL Minimed™ 780G system over a 12-month period.

Results: Within just 14 days of activating the automatic mode, the AHCL Minimed™ 780G system showed rapid improvement in TITR, and in the other continuous glucose monitoring (CGM) metrics. This improvement persisted over 12 months, achieving the proposed 45-50% range for effective glycemic control.

Conclusion: The AHCL Minimed™ 780G system significantly enhances TITR, demonstrating continuous improvement throughout a 12-month follow-up period.

Keywords: Advanced hybrid closed-loop systems; Continuous glucose monitoring metrics; Technology; Time in tight range; Type 1 diabetes.

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Conflict of interest statement

Declarations Conflict of Interest The authors Laura Nigi, Maria De Los Angeles Simon Batzibal, Dorica Cataldo and Francesco Dotta have no conflicts of interest to disclose. Ethical Approval All participants in the study provided written consent for their data to be collected and used for research purposes. The study received approval from the local research ethics committee (Protocol number 24849. Comitato Etico Regionale per la Sperimentazione Clinica della Regione Toscana Sezione: AREA VASTA SUD EST) and adhered to the standards set by the Declaration of Helsinki, as updated in 2013.

Figures

Fig. 1
Fig. 1
Raw data results at different time points. M manual mode, A first 14 days auto-mode, A3mo first 14 days after 3 months auto-mode, A6mo first 14 days after 6 months auto-mode, A12mo first 14 days after 12 months auto-mode. TIR time in range, TITR time in tight range, TBR time below range, TAR time above range, CV glycemic variability, GMI glucose management indicator
Fig. 2
Fig. 2
Results at different time points (M, A, A3mo, A6mo, A12mo): a TIR%, b TITR%, c TBR%, d TAR%, e CV%, f GMI%, g mean glucose (mg/dl). M manual mode, A first 14 days auto-mode, A3mo first 14 days after 3 months auto-mode, A6mo first 14 days after 6 months auto-mode, A12mo first 14 days after 12 months auto-mode. TIR time in range, TITR time in tight range, TBR time below range, TAR time above range, CV glycemic variability, GMI glucose management indicator
Fig. 3
Fig. 3
Comparisons of glycated hemoglobin (HbA1c)% at baseline (T0) and at different time points post-advanced hybrid closed loop (AHCL) initiation (A3mo, A6mo, A12mo). A3mo first 14 days after 3 months auto-mode, A6mo first 14 days after 6 months auto-mode, A12mo first 14 days after 12 months auto-mode
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