Safety and Metabolic Outcomes of Medtronic Minimed 780G Initiation at Diagnosis in Children and Adolescents

Yilmaz Uğur Cem; Günay Demir; Kizilay Deniz Ozalp; Samim Ozen; Damla Goksen

Aim: This study aims to evaluate the comparative effects of the Minimed 780G system initiated at the time of diagnosis and subcutaneous insulin therapy with continuous glucose monitoring (CGM) systems also initiated at the time of diagnosis on metabolic control and CGM metrics.

Methods: We enrolled 8 participants who started using the Minimed780G and 7 participants who started using continuous glucose monitoring (CGM) + multiple daily injections (MDI) at the time of diagnosis. We collected data on CGM metrics at 3, 6, and 12 months. We reviewed CGM measurements and pump settings daily for all participants, then weekly (via phone call and WhatsApp) until the 3rd month of outpatient follow-up.

Results: The mean age at diagnosis was 5.98±3.22 years (0.87-9.82) for Minimed 780G and 9.77±4.89 years (3.70-17.72) for CGM+MDI users. Minimed780G was initiated an average of 3.33±7.73 days (0-23) after discontinuation of IV insulin therapy and CGM+MDI were initiated within 17.37±8.86 days (1-29). The Minimed 780G system significantly improved glycemic control compared to CGM+MDI, with better HbA1c, time in range (TIR), and glucose management indicator, and lower mean blood glucose levels (details in table). Time Below Range increased significantly at 3 months (P = 0.020) but not at 12 months (P = 0.099).

Table: Comparison Between Minimed 780G and CGM+MDI
Metric	Device	Baseline	3 Months	P:	6 Months	P:	12 Months	P:
HbA1c (%)	Minimed780G	11	6.83	0.502	6.73	0.094	6.10	0.021*
	CGM+MDI	11.70	7.13		7.76		7.73
TAR	Minimed780G	13.33	15.44	0.768	17.00	0.219	13.40	0.025*
	CGM+MDI	18.75	14.50		23.50		30.67
TIR (%)	Minimed780G	77.89	77.11	0.190	72.50	0.381	79.00	0.009*
	CGM+MDI	76.00	82.88		65.00		50.67
TBR (%)	Minimed780G	2.78	2.78	0.020*	2.83	0.067	3.80	0.099
	CGM+MDI	1.13	1.00		1.33		1.67
Level2 Hypo	Minimed780G	0.44	0.67	0.050	0.40	0.178	0.80	0.751
	CGM+MDI	0.00	0.00		0.00		0.67
GMI	Minimed780G	6.41	6.74	0.664	6.76	0.146	6.50	0.019*
	CGM+MDI	6.87	6.67		7.25		7.60
Mean BG	Minimed780G	133.56	140.11	0.664	143.80	0.156	133.80	0.022*
	CGM+MDI	146.38	139.88		164.00		179.67
None of the children experienced ketoacidosis or severe hypoglycemic events during follow-up.

Conclusion: Early initiation of Minimed 780G improves long-term glycemic control by reducing HbA1c levels, increasing TIR, and maintaining lower mean blood glucose levels. However, careful monitoring remains essential to mitigate hypoglycemia risk during the honeymoon period. These findings support wider adoption of advanced hybrid closed-loop systems like Minimed 780G in early management of type 1 diabetes.

ESPE Abstracts

P3-291