Adapting for ADAPT: tried and tested

It’s all well and good to say that a product works wonders in the lab. However, when this miraculous product finds itself in the real world, does it really perform as the manufacturers claim? When living with type 1 diabetes, you want to know that this product will actually help you when you’re living your real life in the real world. Recently, there has been a lot of interest in how the MiniMed^TM 780G system performs on real people living their real lives with type 1 diabetes. Collectively, these clinical studies and analysis provide a compelling case for the MiniMed^TM 780G system across a range of ages, genders, and stages in the diabetes journey.^1-3;5-9

The ADAPT study and the MiniMed^TM 780G

The ADAPT study¹, recently published in The Lancet Diabetes & Endocrinology, investigated the impact of the MiniMed^TM 780G system, compared to those on multiple daily injections (MDI) plus intermittently scanned CGM (isCGM) on those living with type 1 diabetes that struggle to manage their glucose level. 82 adults from France, Germany, and the UK with a mean baseline HbA1c of 9% were involved in this clinical trial. Researchers were interested in finding out how using the MiniMed^TM 780G automated insulin delivery system would help to improve:

• HbA1c – the primary outcome of interest.
• Time in range (TIR).
• Time below range (TBR), considered to be hypoglycaemia.
• Time above range (TAR), considered to be hyperglycaemia.

This study has served to confirm the clinical value of the MiniMed^TM 780G in individuals struggling to achieve glucose targets with standard treatment. Compared to MDI and isCGM, within 6 months, the MiniMed^TM 780G system improved:

• Mean HbA1c by 1.4%.
• Mean TIR by 27.6%.
• A significant reduction of TAR with no increase of TBR.
• The number of users reaching their glycaemic targets⁴, including HbA1c and TIR.
• Treatment satisfaction and decrease in fear of hypoglycaemia.

The MiniMed^TM 780G has been tried and tested in the real-world and in multiple studies

Through real world analyses across recent years, the MiniMed^TM 780G system has demonstrated its value for real people living with type 1 diabetes going about their real lives in the real world. One recent analysis3 involving almost 13,000 people across Europe, the Middle East, and Africa found that users, on average, spent 75.8% within the recommended TIR (70mg/dL - 180 mg/dL or 3.9mmol/L -10mmol/L) after initiating the MiniMed^TM 780G system with its SmartGuard^TM algorithm. Further analysis of a specific group of participants (almost 1,500 people) using recommended optimal pump settings found that over 90% of these people achieved their TIR goals⁴ (TIR >70%).

Importantly, various clinical studies have demonstrated that the MiniMed^TM 780G system is able to benefit people at any stage of their diabetes journey. Across age groups, genders, and pre-pump TIR levels, the advanced automation features of the pump allowed more users to reach their glycaemic targets more often.^{1, 5-9}

Imagine being able to engage in your favourite sport and being able to concentrate on winning instead of wondering what your glucose is doing. The pump would correct your insulin delivery automatically while also alert you with a beep if your glucose level is on the way down.

Final thoughts

It can be tricky to know whether that magic product works just as well on your unique body as it does in the infomercial on TV. When it comes to living with type 1 diabetes, sometimes it can just be a matter of trial and error to figure out what works for you and your body. However, when it comes to insulin pumps, it can be comforting to know that it’s already been tried and tested by research (and quite a number of people!).

References

1. Choudhary P et al. Advanced hybrid closed loop therapy versus conventional treatment in adults with type 1 diabetes (ADAPT): a randomised controlled study. Lancet Diab Endocrinol. 2022; 10(10):720-731.
2. Da Silva J, et al. Real-world performance of the MiniMed™ 780G system: first report of outcomes from 4’120 users. Diabetes Technol Ther 2022; Feb;24(2):113-119.
3. Arrieta A et al. Comparison of MiniMed 780G system performance in users aged younger and older than 15 years: Evidence from 12 870 real-world users. Diabetes Obes Metab. 2022. 24:1370–1379.
4. Battelino T, et al. Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range. Diabetes Care. 2019;42(8):1593-1603.
5. Carlson AL, et al. Safety and Glycemic Outcomes During the MiniMed™ Advanced Hybrid Closed-Loop System Pivotal Trial in Adolescents and Adults with Type 1 Diabetes. Diabetes Technol Ther. 2022;24(3):178-189.
6. Collyns OJ, et al. Improved Glycemic Outcomes With Medtronic MiniMed Advanced Hybrid Closed-Loop Delivery: Results From a Randomized Crossover Trial Comparing Automated Insulin Delivery With Predictive Low Glucose Suspend in People With Type 1 Diabetes. Diabetes Care. 2021; 44 (4): 969–975.
7. Bergenstal RM, et al. A comparison of two hybrid closed-loop systems in adolescents and young adults with type 1 diabetes (FLAIR): a multicentre, randomised, crossover trial. Lancet. 2021;397(10270):208-219.
8. Lepore G et al. Switching to the Minimed™ 780G system achieves clinical targets for CGM in adults with type 1 diabetes regardless of previous insulin strategy and baseline glucose control. Acta Diabetol. 2022; 59:1309–1315.
9. Petrovski G et al. Glycemic outcomes of Advanced Hybrid Closed Loop system in children and adolescents with Type 1 Diabetes, previously treated with Multiple Daily Injections (MiniMed 780G system in T1D individuals, previously treated with MDI). BMC Endocr Disord. 2022;22:80.

*Information contained herein is not medical advice and should not be used as an alternative to speaking with your diabetes healthcare team. Discuss indications, contraindications, warnings, precautions, potential adverse events, and any further information with your diabetes healthcare team.