The Transition of Time in Range, Basal Insulin Dose, and Insulin Sensitivity after Introducing a Hybrid Closed Loop of MiniMed 770G in Outpatients with Type 1 Diabetes in Real World Cohort Study.

Abstract

Introduction: MiniMed 770G is a new insulin pump equipped with Hybrid Closed Loop (HCL). Its clinical impact on the actual clinical user in Japanese adolescents is still unclear.

Material and methods: We compared glucose profiles, including HbA1c, Time in Range (TIR), and insulin dose in patients with established type 1 diabetes mellitus who had already used Continuous Glucose Monitoring before the HCL introduction.

Results: Results: Thirty-seven participants were included in the analysis. The median age was 15 years (Median values are used below). Before and three months after HCL introduction, HbA1c significantly decreased from 7.51% to 7.08%, and TIR significantly increased from 60.4% to 69.6%, respectively. Basal insulin as a percentage of total daily insulin dose (Basal%) showed an increasing trend from 32.3% to 37.0%. The stratified analysis revealed that the group with increased Basal% had a significantly lower Basal% before HCL introduction than the group with decreased Basal%. Younger age group showed a significant insulin sensitivity discrepancy of more than 100 between the calculated and the default setting before HCL introduction.

Conclusion: HbA1c and TIR improved after HCL introduction, and the basal% showed an increasing trend. Insulin sensitivity of some younger age group deviated after the HCL introduction, suggesting a risk of hypoglycemia due to HCL.