Switching to a Minimed 780G closed-loop hybrid system: Real-life experience in a center of Latin America

Abstract

IntroductionInsulin pumps serve as alternative insulin delivery methods with physiological similarity to the normal pancreas. The MiniMed 780G device is an advanced closed-loop hybrid system. Recent real-life studies have allowed reaching a higher percentage of time in range (TIR) (70 to 180 mg/dL). Being an emerging technology, it is of the utmost value to report on the early experience of use of this device. MethodsThis was an observational, descriptive, cross-sectional study that included patients older than 18 years with types 1 diabetes mellitus and other types switched to a Medtronic 780G insulin pump. Baseline clinical and glycemic control variables and those after 4 weeks of using the SmartGuard mode were evaluated. ResultsThirty-nine patients (mean age, 33 years) were analyzed, 95 % of whom had type 1 diabetes with an average disease duration of 17 years. The values for time below range (TBR) <54 mg/dL, TBR <70 mg/dL, TIR, time above range (TAR) >180 mg/dL, and TAR >250 mg/dL were 0 %, 3 %, 72 %, 21 %, and 3 %, respectively, at baseline and 1 %, 2 %, 79 %, 14 %, and 2 %, respectively, after the intervention. The changes in TIR varied based on prior therapy: multiple daily injections of insulin, 13 % improvement; MiniMed Paradigm Veo/MiniMed 640G, 6 % improvement; and MiniMed 670G, −4 % improvement. ConclusionIn conclusion, the application of a hybrid closed-loop system allowed for better glycemic control based on international standards. The average percentage improvement in TIR was lower than that in other studies and was dependent on the previous method of insulin administration, achieving lower performance with the migration from recent technologies such as the Minimed 670G.