Overnight to Early-Morning Glycemic Outcomes in Children Using the MiniMed™ 670G Hybrid Closed-Loop (HCL) System

Abstract

In-home use of the MiniMed™ 670G system with SmartGuard™ technology for 3 months improved A1C, 24-hour, and overnight (10PM-7AM) glycemia in T1D patients ≥14 years.1 Recently, the system was shown to improve A1C and time in target range (TIR) (>70-180mg/dL, 3.9-10mmol/L) during 24-h and overnight periods in T1D children aged 7-13 years. Effect of the system on insulin delivery and early morning glycemia was also examined. During a 2 week run-in phase in Manual Mode and a 3-month study phase using HCL Auto Mode; 24-hour, 10PM-7AM, and 3AM-7AM insulin delivery (programmed hourly basal rates during Manual Mode, variable basal from 0 units to an individualized daily maximum every 5min during Auto Mode); time in sensor glucose (SG) ranges; and SG SD were examined in 1T1D children (mean±SD age 10.8±1.8 years). The table shows Auto Mode use across periods. Total insulin delivered increased from baseline run-in (1990 patient-days) through study phase (10,602 patient-days); SG, TIR, and SG SD improved. During the study phase, there was no severe hypoglycemia, DKA, or serious device-related AEs. The ability of the MiniMed™ 670G system to automate basal insulin delivery and safely improve 24-hour and overnight glycemic control in children was comparable to that observed in patients 14-75 years, over 3 months. Improved early morning glycemia further indicates that patients ≥7 years can benefit from this HCL therapy. Disclosure G.P. Forlenza: Advisory Panel; Self; Dexcom, Inc.. Research Support; Self; Medtronic, Tandem Diabetes Care, Inc., Insulet Corporation, Dexcom, Inc., Novo Nordisk Inc., Bigfoot Biomedical. D.I. Shulman: Other Relationship; Self; Novo Nordisk Inc.. Research Support; Self; Medtronic MiniMed, Inc.. Board Member; Self; Pediatric Endocrine Society. Research Support; Self; Versartis, Inc. M.A. Wood: Research Support; Self; Medtronic MiniMed, Inc. T.S. Bailey: Research Support; Self; Abbott. Consultant; Self; Abbott. Speaker's Bureau; Self; Abbott. Research Support; Self; Ambra BioScience, Ascensia Diabetes Care, Becton, Dickinson and Company. Consultant; Self; Becton, Dickinson and Company. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Calibra Medical. Consultant; Self; Calibra Medical. Research Support; Self; Companion Medical, Dexcom, Inc., Glooko, Inc., GlySens Incorporated, Lexicon Pharmaceuticals, Inc., Eli Lilly and Company. Consultant; Self; Eli Lilly and Company. Speaker's Bureau; Self; Eli Lilly and Company. Research Support; Self; Medtronic MiniMed, Inc.. Consultant; Self; Medtronic MiniMed, Inc.. Speaker's Bureau; Self; Medtronic MiniMed, Inc.. Research Support; Self; Novo Nordisk Inc.. Consultant; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc.. Research Support; Self; Sanofi. Consultant; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Research Support; Self; Senseonics. Consultant; Self; Intarcia Therapeutics, Inc.. Research Support; Self; Versartis, Inc., Xeris Pharmaceuticals, Inc., MannKind Corporation. B.W. Bode: Research Support; Self; Abbott. Advisory Panel; Self; ADOCIA. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Consultant; Self; Janssen Pharmaceuticals, Inc.. Research Support; Self; GlaxoSmithKline plc., Lexicon Pharmaceuticals, Inc., Medtronic MiniMed, Inc., Novo Nordisk Inc., Diasome Pharmaceuticals, Inc., Sanofi US, Eli Lilly and Company, MannKind Corporation, Dexcom, Inc., OmniPod, Senseonics. B. Buckingham: Advisory Panel; Self; Novo Nordisk Inc., ConvaTec Inc.. Research Support; Self; Medtronic, Insulet Corporation, Dexcom, Inc., Tandem Diabetes Care, Inc.. Consultant; Self; Tandem Diabetes Care, Inc., Becton, Dickinson and Company. S. Huang: Employee; Self; Medtronic. J. Shin: Employee; Self; Medtronic. S.W. Lee: Employee; Self; Medtronic. T.L. Cordero: Employee; Self; Medtronic. F.R. Kaufman: Employee; Self; Medtronic.