Clinical Outcomes with MiniMedTM 780G Advanced Hybrid Closed-Loop Therapy In Children <7 years with Type 1 Diabetes

Uslu Nihal Gül; Kizilay Deniz Ozalp; Gunay Demir; Altinok Yasemin Atik; Sukran Darcan; Samim Ozen; Damla Goksen

Objectives: Advanced hybrid closed-loop (AHCL) therapy with the Medtronic MiniMed™ 780G system improves glycemia; however, the clinical outcomes in younger children remain less established. The evaluation of the use of the Medtronic Minimed^TM 780G in children under 7 years old was aim ed.

Methods: Children under 7 years old with type 1 diabetes mellitus (T1D) using MiniMed™ 780G AHCL and a control group of similar age and gender using MiniMed™ 640G (Predictive Low Glucose Suspend System - PLGS), and T1D patients on multiple-dose insulin (MDI) with continuous glucose monitoring system (CGM) were included. CGM metrics and HbA1c were retrospectively evaluated at baseline, 3, 6, and 12 months.

Results: Mean age at initiation was 5.25±1.22 years. TDI was initially 4,5-17,6U/day (min-max). Glucose management indicator (GMI) and HbA1c values were significantly lower at 3, 6, and 12 months compared to baseline. (P <0.001, respectively) When AHCL was compared to MDI+CGM and PLGS, Time Above Range (TAR) was significantly lower at the 3rd, 6th, and 12th months, while HbA1c and Coefficient of variation (CV) values were significantly lower at the 12th months in the AHCL group. Time In Range (TIR) value was significantly higher in the 3rd and 12th months. No cases of ketoacidosis or severe hypoglycemic events were observed in any of the children during the monitoring period.

**Table 1: Comparison between Minimed^TM 780G and Minimed^TM 640G and CGM+multi-dose Subcutaneous insulin users.**
%	0-month			p	3-month			p	6-month			p	12-month			p
%	780G	640G	CGM	p	780G	640G	CGM	p	780G	640G	CGM	p	780G	640G	CGM	p
TAR	23,7±12,7	32,4±12,7	33,6±19,8	0,107	18,4±7,3	36,5±17,9	34,3±15,5	0,018	20±5,9	39±18,7	36,6±19,4	0,017	21,2±8,9	31,3±10,7	37,2±19,4	0,04
TIR	70±16	63,8±13,8	64,7±19,7	0,239	76,7±7,1	59,6±17,5	63,6±15,1	0,026	72,5±15,6	57,3±17,9	60,5±19,1	0,120	75,9±7,7	64,7±9,7	59,1±18,7	0,019
TBR	3,3±3,1	3,8±2,4	1,6±1,1	0,061	4,6±2,9	3,7±2,8	2,4±2,3	0,178	3,6±2,4	3,7±2,6	3±2,2	0,746	3±2,1	4±3,1	3,7±3	0,944
CGM: Continuous Glucose Monitoring; TAR: Time Above Range; TIR: Time In Range; TBR: Time Below Range Although TIR didn’t show any significant increase when 12 months were statistically examined together, it was significantly changed between the initial time the 3rd month (P <0,001)

Conclusion: The findings of the study indicates that AHCL is both reliable and effective in children under 7 years old.

ESPE Abstracts

P2-67