Safety and glycaemic control during exercise with the MiniMed™ 780G: A narrative review of evidence from lab to real world.

Abstract

Physical activity plays a critical role in reducing cardiovascular risk among individuals with type 1 diabetes (PwT1D); however, more than two-thirds of PwT1D remain insufficiently active, primarily due to the unpredictability of glucose fluctuations and the fear of hypoglycaemia during exercise. Automated insulin delivery systems, such as the MiniMed™ 780G (MM780G), offer potential solutions by automating insulin dosing, supporting stable glucose control, and allowing for a higher temporary glucose target. This narrative review summarizes the current evidence on the safety and efficacy of the MM780G system during exercise in PwT1D, with a focus on the temporary target (TT) feature and real-world usability. The MM780G consistently supports glycaemic safety during exercise, especially moderate-intensity aerobic activity, with time in range frequently meeting or exceeding consensus guidelines. Activation of the TT feature 60- to 120-min pre-exercise, particularly when paired with reduced meal boluses, significantly lowers the risk of hypoglycaemia. Real-world studies confirm its safety across varied activities, including prolonged aerobic exercise and contact sports. While evidence for resistance and high-intensity exercise remains limited, initial findings are favourable. User education is crucial to optimize use, particularly in competitive and prolonged settings. The MM780G is a safe and effective tool for glycaemic management during exercise in PwT1D. Best outcomes are achieved through strategic use of the TT feature and meal bolus reduction, individualized carbohydrate strategies and proper education. Applying easy-to-follow pre-exercising recommendations may encourage better engagement with regular exercising. Further research is needed on long-term adaptations to training and resistance-based exercise protocols.