Medtronic, Northridge, California, USA.
Medtronic International Trading Sàrl, Tolochenaz, Switzerland.
Diabetes Technol Ther. 2023 Sep;25(9):652-658. doi: 10.1089/dia.2023.0123. Epub 2023 Jun 16.
Safety and significant improvement in overall glycated hemoglobin (A1C) and percentage of time spent in (TIR), below (TBR), and above (TAR) glucose range were demonstrated in the pivotal trial of adolescents and adults using the MiniMed™ advanced hybrid closed-loop (AHCL) system with the adjunctive, calibration-required Guardian™ Sensor 3. The present study evaluated early outcomes of continued access study (CAS) participants who transitioned from the pivotal trial investigational system to the approved MiniMed™ 780G system with the non-adjunctive, calibration-free Guardian™ 4 Sensor (MM780G+G4S). Study data were presented alongside those of real-world MM780G+G4S users from Europe, the Middle East, and Africa. The CAS participants ( = 109, aged 7-17 years and = 67, aged >17 years) used the MM780G+G4S for 3 months and data of real-world MM780G+G4S system users ( = 10,204 aged ≤15 years and = 26,099 aged >15 years) were uploaded from September 22, 2021 to December 02, 2022. At least 10 days of real-world continuous glucose monitoring (CGM) data were required for analyses. Glycemic metrics, delivered insulin and system use/interactions underwent descriptive analyses. Time in AHCL and CGM use were >90% for all groups. AHCL exits averaged 0.1/day and there were few blood glucose measurements (BGMs) (0.8/day-1.0/day). Adults in both cohorts met most consensus recommendations for glycemic targets. Pediatric groups met recommendations for %TIR and %TBR, although not those for mean glucose variability and %TAR, possibly due to low use of recommended glucose target (100 mg/dL) and active insulin time (2 h) settings (28.4% in the CAS cohort and 9.4% in the real-world cohort). The CAS pediatric and adult A1C were 7.2% ± 0.7% and 6.8% ± 0.7%, respectively, and there were no serious adverse events. Early clinical use of the MM780G+G4S was safe and involved minimal BGMs and AHCL exits. Consistent with real-world pediatric and adult use, outcomes were associated with achievement of recommended glycemic targets. Clinical Trial Registration number: NCT03959423.
在使用 MiniMed™ 高级混合闭环 (AHCL) 系统与附加、需要校准的 Guardian™ 传感器 3 的青少年和成年人的关键试验中,证明了安全性和糖化血红蛋白 (A1C) 的整体显著改善,以及 TIR 以下 (TBR)、TAR 以上 (TAR) 的葡萄糖范围的时间百分比。本研究评估了从关键试验研究系统过渡到经批准的 MiniMed™ 780G 系统(非附加、无需校准的 Guardian™ 4 传感器 [MM780G+G4S])的持续访问研究 (CAS) 参与者的早期结果。研究数据与来自欧洲、中东和非洲的真实世界 MM780G+G4S 用户的数据一起呈现。CAS 参与者( = 109 名 7-17 岁, = 67 名 >17 岁)使用 MM780G+G4S 进行了 3 个月,从 2021 年 9 月 22 日到 2022 年 12 月 2 日,上传了真实世界 MM780G+G4S 系统用户的( = 10,204 名 ≤15 岁, = 26,099 名 >15 岁)的真实世界数据。分析需要至少 10 天的真实连续血糖监测 (CGM) 数据。血糖指标、输送胰岛素和系统使用/交互作用进行了描述性分析。所有组的 AHCL 和 CGM 使用时间均超过 90%。AHCL 退出平均每天 0.1 次,血糖测量(BGM)次数很少(每天 0.8 次-1.0 次)。两个队列中的成年人均符合大多数血糖目标共识建议。儿科组符合 TIR 和 TBR 的建议,尽管不符合平均血糖变异性和 TAR 的建议,这可能是由于推荐的血糖目标(100mg/dL)和活跃胰岛素时间(2 小时)设置的使用率低(CAS 队列中为 28.4%,真实世界队列中为 9.4%)。CAS 儿科和成人 A1C 分别为 7.2%±0.7%和 6.8%±0.7%,且无严重不良事件。MM780G+G4S 的早期临床应用是安全的,涉及最少的 BGM 和 AHCL 退出。与真实世界的儿科和成人使用一致,结果与实现推荐的血糖目标相关。临床试验注册号:NCT03959423。