Twelve-Month Real-World Use of an Advanced Hybrid Closed-Loop System Versus Previous Therapy in a Dutch Center For Specialized Type 1 Diabetes Care.

IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Science and Technology Pub Date : 2024-10-28 DOI:10.1177/19322968241290259

Pim Dekker, Tim van den Heuvel, Arcelia Arrieta, Javier Castañeda, Dick Mul, Henk Veeze, Ohad Cohen, Henk-Jan Aanstoot

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引用次数: 0

Abstract

Background: Complexity of glucose regulation in persons with type 1 diabetes (PWDs) necessitates increased automation of insulin delivery (AID). This study aimed to analyze real-world data over 12 months from PWDs who started using the MiniMed 780G (MM780G) advanced hybrid closed-loop (aHCL) AID system at the Diabeter clinic, focusing on glucometrics and clinical outcomes.

Methods: Persons with type 1 diabetes switching to the MM780G system were included. Clinical data (e.g. HbA1c, previous modality) was collected from Diabeter's electronic health records and glucometrics (time in range [TIR], time in tight range [TITR], time above range [TAR], time below range [TBR], glucose management indicator [GMI]) from CareLink Personal for a 12-month post-initiation period of the MM780G system. Outcomes were age-stratified, and the MM780G system was compared with previous use of older systems (MM640G and MM670G). Longitudinal changes in glucometrics were also evaluated.

Results: A total of 481 PWDs were included, with 219 having prior pump/sensor system data and 334 having monthly longitudinal data. After MM780G initiation, HbA1c decreased from 7.6 to 7.1% (P < .0001) and the percentage of PWDs with HbA1c <7% increased from 30% to 50%. Glucose management indicator and TIR remained stable with mean GMI of 6.9% and TIR >70% over 12 months. Age-stratified analysis showed consistent improvements of glycemic control across all age groups, with older participants achieving better outcomes. Participants using recommended system settings achieved better glycemic outcomes, reaching TIR up to 77% and TTIR up to 55%.

Conclusions: Use of MM780G system results in significant and sustained glycemic improvements, consistent across age groups and irrespective of previous treatment modalities.

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荷兰 1 型糖尿病专科护理中心使用先进的混合闭环系统与以往疗法进行为期 12 个月的实际对比。

背景：1 型糖尿病患者（PWDs）血糖调节的复杂性要求提高胰岛素给药（AID）的自动化程度。本研究旨在分析在 Diabeter 诊所开始使用 MiniMed 780G (MM780G) 高级混合闭环 (aHCL) AID 系统的 1 型糖尿病患者在 12 个月内的实际数据，重点关注血糖测量和临床结果：方法：纳入改用 MM780G 系统的 1 型糖尿病患者。从 Diabeter 的电子健康记录中收集临床数据（如 HbA1c、以前的治疗方式），并从 CareLink Personal 收集 MM780G 系统启动后 12 个月内的血糖测量数据（在量程内的时间 [TIR]、在紧量程内的时间 [TITR]、高于量程的时间 [TAR]、低于量程的时间 [TBR]、血糖管理指标 [GMI]）。结果按年龄进行了分层，并将 MM780G 系统与之前使用的旧系统（MM640G 和 MM670G）进行了比较。此外，还对血糖测量的纵向变化进行了评估：结果：共纳入了 481 名残疾人，其中 219 人之前使用过泵/传感器系统，334 人每月使用纵向数据。使用 MM780G 后，HbA1c 从 7.6 降至 7.1%（P < .0001），12 个月内 HbA1c 下降 70% 的残疾人比例。年龄分层分析表明，所有年龄组的血糖控制都得到了一致的改善，年龄较大的参与者取得了更好的结果。使用推荐系统设置的参与者取得了更好的血糖控制效果，TIR 达到 77%，TTIR 达到 55%：结论：使用 MM780G 系统可显著、持续地改善血糖，这与不同年龄组的情况一致，也与之前的治疗方式无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes Science and Technology Medicine-Internal Medicine

CiteScore

7.50

自引率

12.00%

发文量

148

期刊介绍： The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.