A narrative review of meal management with the MiniMed™ 780G system: Evolution of dietary management in type 1 diabetes.

BACKGROUND

Type 1 diabetes (T1D) meal management has long relied on structured carbohydrate counting and rigid bolus timing to achieve optimal glycaemic outcomes. However, these strategies impose a cognitive burden and are difficult to sustain in daily life. This narrative review evaluates how the MiniMed™ 780G Automated Insulin Delivery (AID) system enables revisiting management strategies with simplified and flexible approaches without significantly compromising clinical efficacy.

METHODS

A narrative review was conducted based on published clinical studies and real-world evidence (RWE) papers collected from MiniMed™ 780G system users. The analysis focused on meal bolusing patterns, unannounced meals, carbohydrate counting strategies, high-fat/high-protein diets, fasting regimens, and other meal-related conditions.

RESULTS

Evidence suggests that the MiniMed™ 780G system provides significant flexibility in meal management without compromising glycaemic outcomes. Comparable time in range (TIR) was observed whether insulin was bolused pre-meal or at meal start, although delaying bolusing beyond 30 min post-meal led to greater glucose excursions. The system demonstrated the capability to compensate for missed meal boluses of up to 30 g of carbohydrates. Predefined fixed meal bolusing strategies may be more convenient for people with diabetes who are hesitant to perform precise carbohydrate counting, yet they can still achieve international glycaemic targets. Additionally, the system effectively adapts to high-fat, high-protein meals and fasting regimens, such as those observed during Ramadan, with minimal impact on TIR. Real-world data from over 61 000 users confirm that adherence to the system's optimal settings (glucose target of 100 mg/dL, active insulin time 2 h) and the use of 2-3 carbohydrate ratios per day resulted in the greatest glycaemic benefit.

CONCLUSION

The MiniMed™ 780G system shifts the paradigm of meal management in T1D from intensive self-regulation toward automation and behavioral sustainability. These findings support broader access to AID technology by reducing reliance on precise carb counting and aligning therapy with real-world needs.