Comparison of the night-time effectiveness in achieving glycemic targets in adults with type 1 diabetes of three advanced hybryd closed-loop systems

Advanced hybrid closed loop (AHCL) systems currently represent the most advanced modality of insulin therapy.

To compare the night-time (from 00 to 07 a.m.) effectiveness in achieving recommended glycemic targets of three different AHCL systems in adults with type 1 diabetes (T1D).

We retrospectively evaluated 55 adults with T1D (mean age 41 ± 16 years, male 40%, diabetes duration 19.4 ± 11.4 years, BMI 24.1 ± 4.1 kg/m²) with similar glycemic control (GMI 7.0–7.4%). Twenty-two participants were using the Minimed 780G system, 18 the Tandem t:slim X2 with Control-IQ system and 15 the DBLG1 system.

Continuous glucose monitoring derived metrics and insulin requirement of 14 consecutive nights were analyzed.

All three groups achieved the recommended mean TIR > 70%, mean TBR < 4%, and mean CV < 36% with a similar insulin requirement (Minimed 780G system: TIR 73.9 ± 11.2%, TBR 0.9 ± 1.2%, CV 29 ± 6.7%; Tandem t:slim X2 with Control-IQ system: TIR 74.1 ± 11.1%, TBR 1.1 ± 1.0%, CV 34.5 ± 6.6%; DBLG1 System TIR 71.7 ± 11.3%, TBR 1.4 ± 3.7%, CV 32.4 ± 7.1%). Tight TIR% (70–140 mg/dl) was significantly higher (p < 0.01) in the Tandem t:slim X2 with Control-IQ group (51.5 ± 9.8%) when compared to Minimed 780G group (42.1 ± 13.7%) and DBLG1 System (40.1 ± 10.5%). In all three groups the insulin infusion similarly decreased from midnight to 05.00 am and then increased.

All the three AHCL systems achieved the recommended TIR, TBR and CV without difference in insulin requirement. The Tandem Control-IQ system obtained a higher tight TIR.