Background: Advanced Hybrid Closed Loop (AHCL) system includes an algorithm that provides both automated basal rate and correction boluses to keep glycemic values in a target range. Patients are only required to estimate carbohydrate consumption for meal boluses.
Objectives: To evaluate the real-world performance of the MiniMed TM 780G system in Egyptian patients with type 1 diabetes.
Methods: Data uploaded from October 2021 to March 2022 were aggregated and retrospectively analyzed. Percentage of time spent within (TIR= 70–180 mg/dl), below (TBR) and above (TAR) glycemic ranges, the mean glucose management indicator (GMI), system use, and insulin consumed in users with 14 or more days of sensor glucose data after initial auto mode start were determined. Baseline and follow-up visits at days 7 and 180 were carried out; data were downloaded at each visit. 34.3% (n = 22) of patients previously used sensor augmented pump-predictive low glucose management (SAP-PLGM), with baseline HbA1c 7.8% ± 1% were included. The paired student t-test was used and a value<0.05 was considered statistically significant.
Results: Users (n = 64, aged 8–24 years, males represents 54 % of participants) spent a mean of 88.4% of the time in auto mode (SmartGuard). When compared with pre-auto mode initiation, time in range significantly increased from 64.6% at baseline to 75.1 %, and 79.6 % at days 7 and days 180 respectively (P<0.001). Time above range (for both >180 mg/dL and time >250 mg/dL) significantly decreased from 28.2% to 17.9% (P< 0.001), while time below range (for both <70 mg/dL and time <54mg/dL) significantly decreased from 7.2% to 2.5% (P< 0.001). Mean glucose levels were reduced from 167.5 mg/dL at baseline to 131.4 mg/dL (P< 0.001) at last visit. Coefficient of variation (%) decreased from 38.4% to 30.5%. Significantly improved glycemic control was observed as GMI was reduced by 0.8% ± 0.3% while the total daily dose of insulin increased mostly due to increased basal insulin delivery(auto-basal). Average set and reservoir change was 3.2±0.4 days and mean blood glucose calibration per day was 3.6 times. No episodes of severe hypoglycemia or DKA were reported.
Conclusions: Most MiniMed TM 780G system users in Egypt achieved TIR more than 70% and GMI less than 7% while minimizing hypoglycemia, in a real-world environment with no serious adverse effects. The international consensus outcomes were enabled by automated insulin delivery; meeting real-time insulin requirements adapted to each individual user.
15 Sep 2022 - 17 Sep 2022