Amelioration of user experiences and glycaemic outcomes with an Advanced Hybrid Closed Loop System in a real-world clinical setting

Aims: Automation in diabetes technology is rapidly evolving. The aim was to evaluate the real-world glycemic outcomes and user acceptance after 3 months of using the Medtronic 780G Advanced Hybrid Closed-Loop (AHCL) system. Methods: A prospective analysis was performed. A glucose target of 100 mg/dl and an active insulin time of 2 h were set. Capillary HbA1c, 2-week of pump and sensor data and several satisfaction questionnaire scores were compared at baseline and after 3 months of using the AHCL system. Results: 52 subjects were selected (age: 43 +/- 12 years, sex: 73% female, diabetes duration: 27 +/- 11 years, higher education: 31%). Time in range (TIR) 70-180 mg/dl increased from 67.3 +/- 13.6% to 80.1 +/- 7.5% and time >180 mg/dl and >250 mg/dl were reduced (16.8 +/- 8.4 vs 29.4 +/- 15.1%, 2.7 +/- 3.0% vs 6.9 +/- 7.8%, respectively) (all p < 0.001), while time in hypoglycaemia remained below recommended targets. Time in Auto-Mode and sensor use were 94 +/- 10% and 90 +/- 11%, respectively. Auto-correction boluses represented 29 +/- 12% of bolus insulin. Fear of hypoglycaemia, diabetes quality of life, sleep quality and satisfaction with the monitoring system improved after 3 months. Conclusion: The real-world use of the AHCL system Medtronic 780G provides an 80.1% TIR 70-180 mg/dl with minimal hypoglycaemia and an increased level of patient satisfaction. (c) 2021 Elsevier B.V. All rights reserved.

Automated summary

After 3 months of using the Medtronic 780G Advanced Hybrid Closed-Loop (AHCL) system, the time in range (TIR) for blood glucose levels between 70-180 mg/dl increased from 67.3% to 80.1%, with reduced risk of hypoglycemia. Patient satisfaction with the system also improved.