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美敦力™780G高级混合闭环系统在美国≥65岁1型或2型糖尿病患者中的真实世界有效性

Real-World Effectiveness of the MiniMed™ 780G Advanced Hybrid Closed-Loop System for People ≥65 Years with Type 1 or Type 2 Diabetes in the United States.

作者信息

Chien Albert, Shin John J, Liu Margaret, Arrieta Arcelia, Cordero Toni L, Swensen Andrine R, Vigersky Robert A

机构信息

Medtronic Diabetes, Northridge, California, USA.

Medtronic Bakken Research Center, Maastricht, The Netherlands.

出版信息

Diabetes Technol Ther. 2025 Dec;27(12):989-996. doi: 10.1177/15209156251376654. Epub 2025 Sep 16.

Abstract

Multiple daily injections therapy in older adults with diabetes can negatively impact glycemic control and comorbidities. This issue may be overcome with advanced diabetes technology that reduces hypoglycemia and hyperglycemia. The present study evaluated real-world glycemic outcomes of a United States (US) cohort ≥65 years using the MiniMed™ 780G (MM780G) advanced hybrid closed-loop system. CareLink™ personal data as of December 18, 2024, for U.S. MM780G system users ≥65 years, were de-identified and analyzed. Metrics, including time in range (TIR 70-180 mg/dL), time in tight range (TITR 70-140 mg/dL), time below range 70 mg/dL (TBR70), and time above range 180 mg/dL and 250 mg/dL (TAR180 and TAR250, respectively), with and without recommended optimal settings (ROS, 100 mg/dL glucose target with 2 h active insulin time) were determined. Subanalyses based on age group (≥75 years) and type 1 diabetes (T1D) or type 2 diabetes (T2D) were, also, conducted. The overall cohort ( = 8542) had a mean TIR, TITR, TBR70, TAR180, and TAR250 of 78.4%, 51.4%, 0.9%, 20.7%, and 3.6%, respectively, with a 6.8% glucose management indicator. For ROS users ( = 2753), TIR and TITR were higher (81.9% and 55.9%, respectively, < 0.001), and TAR180 and TAR250 were lower (17.2% and 2.5%, respectively, < 0.001). Data trended similarly among the population aged ≥75 years, and no differences were observed between T1D and T2D. In a real-world setting, a U.S. cohort aged ≥65 years using the MM780G system achieved consensus-recommended glycemic targets. Use of ROS enabled more users to achieve an even higher level of glycemic control.

摘要

老年糖尿病患者每日多次注射治疗可能会对血糖控制和合并症产生负面影响。先进的糖尿病技术可以减少低血糖和高血糖,从而克服这一问题。本研究使用美敦力780G(MM780G)先进混合闭环系统评估了美国≥65岁队列的实际血糖结果。对截至2024年12月18日的美国MM780G系统≥65岁用户的CareLink™个人数据进行了去识别和分析。确定了各项指标,包括处于目标范围时间(TIR,70-180mg/dL)、处于严格目标范围时间(TITR,70-140mg/dL)、低于70mg/dL的时间(TBR70)以及高于180mg/dL和250mg/dL的时间(分别为TAR180和TAR250),并比较了有无推荐最佳设置(ROS,血糖目标为100mg/dL且活性胰岛素时间为2小时)时的情况。还根据年龄组(≥75岁)以及1型糖尿病(T1D)或2型糖尿病(T2D)进行了亚组分析。总体队列(n = 8542)的平均TIR、TITR、TBR70、TAR180和TAR250分别为78.4%、51.4%、0.9%、20.7%和3.6%,血糖管理指标为6.8%。对于使用ROS的用户(n = 2753),TIR和TITR更高(分别为81.9%和55.9%,P < 0.001),TAR180和TAR250更低(分别为17.2%和2.5%,P < 0.001)。≥75岁人群的数据趋势相似,T1D和T2D之间未观察到差异。在实际环境中,使用MM780G系统的美国≥65岁队列达到了共识推荐的血糖目标。使用ROS使更多用户能够实现更高水平的血糖控制。

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