| Title: | Insulin delivery characteristics and glycemic control in older adults with type 1 diabetes using the Minimed™ 780G system : a real-world analysis |
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| Authors: | ID Volčanšek, Špela (Author)
ID Vidmar, Petra (Author)
ID Janež, Andrej (Author)
ID Skvarča, Aleš (Author) |
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| Files: |  PDF - Presentation file, download (2,38 MB)
MD5: 9F27D44220B3F8C1DD688E52521F5EF9
 URL - Source URL, visit https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2026.1910192/full
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| Language: | English |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: |  UKC LJ - Ljubljana University Medical Centre
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| Abstract: | Introduction: Diabetes self-management in older adults with type 1 diabetes (T1D) presents a unique clinical challenge, since maintaining tight glycemic control must be carefully weighed against age-related vulnerabilities. This study aimed to analyze glycemic control through the effects of customized algorithm settings in a cohort of older adults with T1D using an automated insulin delivery (AID) system. Methods: This retrospective real-world data analysis included users of the MiniMed™ 780G AID system, aged ≥60 years. Continuous glucose monitoring (CGM) data including time in range (TIR; 70–180 mg/dL; 3.9–10.0 mmol/L), time in tight range (TITR; 70–140 mg/dL; 3.9–7.8 mmol/L), time below range (TBR; <70 mg/dL; <3.9 mmol/L), level 2 TBR (<54 mg/dL; <3.0 mmol/L) and time above range (TAR; >180 mg/dL; >10.0 mmol/L) were analyzed alongside algorithm settings and daily insulin use. Group comparisons utilized standard parametric and non-parametric statistical tests. A multivariable logistic regression model identified independent clinical predictors of high glycemic performance (TITR ≥50%). Results: The cohort comprised 97 AID users (70.1% female, mean age 67.9 ± 6.7; range 60–90 years). Overall glycemic control was good, with mean TIR 76.1%, TITR 51.1% and TBR 1.1%. Fourteen participants (14.4%) used the manufacturer’s recommended optimal settings (ROS); i.e., target glucose of 5.5 mmol/L and active insulin time of 2 hours. CGM metrics did not differ between ROS and non-ROS users for TIR, TITR and TBR. When stratifying the cohort by glycemic performance, 55 participants (56.7%) reached TITR ≥50%; however, the adoption of ROS in high (≥50%) TITR and lower (<50%) TITR subgroups was similar (16.4% vs 11.9%; Fisher p=0.58). When compared to the lower TITR subgroup, participants in the high TITR subgroup delivered less auto-correction insulin (14.2% vs 20.6%, p<0.001) and a higher proportion of manual bolus insulin (46.1% vs 35.2%, p<0.001), which remained a significant predictor of high TITR after multivariable adjustment. TBR was significantly higher in the high (≥50%) TITR subgroup, although it remained low in absolute terms (1.5% vs. 0.8%; p=0.017). Conclusion: While the MiniMed™ 780G AID system use is associated with low CGM-derived hypoglycemia exposure and highly effective glycemic control, regardless of customized settings, superior glycemic control is associated with a higher proportion of user-initiated manual boluses. The algorithm supports, but cannot replace, user engagement. |
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| Keywords: | type 1 diabetes, automated insulin delivery, advanced technologies |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Year of publishing: | 2026 |
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| Number of pages: | str. 1-9 |
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| Numbering: | Vol. 17 |
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| PID: | 20.500.12556/DiRROS-31854  |
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| UDC: | 616.379 |
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| ISSN on article: | 1664-2392 |
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| DOI: | 10.3389/fendo.2026.1910192 |
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| COBISS.SI-ID: | 287200259 |
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| Note: | Nasl. z nasl. zaslona;
Opis vira z dne 7. 8. 2026;
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| Publication date in DiRROS: | 12.08.2026 |
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| Views: | 46 |
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| Downloads: | 25 |
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