Effectiveness and Safety of the MiniMed 780G Advanced Hybrid Closed-Loop System in Older Adults With Type 1 Diabetes: A Comparative Cohort Study.

Abstract

Objective: Evidence on advanced hybrid closed-loop (AHCL) systems in older adults with type 1 diabetes (T1D) remains limited. This study compared the effectiveness and safety of the MiniMed 780G system between adults aged ≥60 years and younger adults.

Methods: We conducted a cross-sectional study in patients with T1D using the MiniMed 780G system. Eligible participants were aged ≥40 years and had used the device for at least four weeks before study entry. Clinical variables, body composition, grip strength, and glycemic outcomes were compared according to age group (<60 vs. ≥60 years).

Results: A total of 118 patients were included, 45% of whom were aged ≥60 years. In this group, 79% were independent for basic activities of daily living and 60% used SmartGuard at optimal settings. Glycemic management was similar in both age groups, including time in range (76.58±8.59 vs. 76.73±9.58; p=0.535), time in tight range (52.0±10.02 vs. 52.75±10.73; p=0.694), and time below range <70 mg/dL (1.39±1.33 vs. 1.81±1.39; p=0.100). In adjusted ANCOVA models, age group was not significantly associated with either TIR or TITR. Optimal SmartGuard settings, grip strength, fat mass, and phase angle were more strongly associated with glycemic profile than age.

Conclusions: MiniMed 780G use was safe and effective in older adults with T1D, achieving glycemic outcomes comparable to younger adults. Optimal SmartGuard settings are associated with a better metabolic profile and should be considered regardless of age. Additionally, grip strength and body composition should be included in the clinical assessment of patients with T1D using AHCL systems.