Objective: To assess the effect of the MiniMed™ 780G Advanced Hybrid Closed Loop (AHCL) system compared to MDI with isCGM (MDI+isCGM) therapy on treatment satisfaction (TS) and fear of hypoglycemia (FoH) , in adults with type 1 diabetes (T1D) with above-target baseline glycemic control participating in the ADAPT study.

Methods: Participants with T1D who were on MDI+isCGM and who had suboptimal glycemic control (HbA1c≥8%) were randomly assigned to AHCL or to continue MDI+isCGM. Treatment satisfaction was measured with the Diabetes-Treatment-Satisfaction-Questionnaire, status (DTSQs) and change (DTSQc) and FoH with the Hypoglycemia Fear Survey (HFS) .

Results: Overall, the decrease in HbA1c was 1.4% greater in the AHCL group vs. MDI+isCGM group (P<0.001) with no difference in hypoglycemia. Mean DTSQs score increased significantly in the AHCL arm after 6 months compared to the MDI+isCGM arm (29.7 vs. 21.9, P=0.0003) , with significant improvement in perceived frequency of hyperglycemia (P<0.001) . There was no difference in the perceived frequency of hypoglycemia. Results were consistent in both DTSQs and DTSQc. Fear of hypoglycemia decreased in both groups, but the decrease was significantly greater in the AHCL group. At 6 months, HFS scores decreased by 10.2 points and 2.7 points from baseline in the AHCL and MDI+isCGM groups, respectively (P=0.04) .

Conclusion: AHCL therapy improves patient-reported outcomes with greater treatment satisfaction and reduced FoH compared to MDI+isCGM in sub-optimally controlled participants with T1D.


S.De portu: Employee; Medtronic. J.Castañeda: Employee; Medtronic. O.Cohen: Employee; Medtronic. Adapt study group: n/a. P.Choudhary: Advisory Panel; Abbott Diabetes, Lilly Diabetes, Medtronic, Research Support; Novo Nordisk, Speaker's Bureau; Dexcom, Inc., Glooko, Inc., Insulet Corporation, Sanofi. J.Kroeger: Advisory Panel; Abbott Diabetes, Dexcom, Inc., Other Relationship; AstraZeneca, Berlin-Chemie AG, Boehringer Ingelheim International GmbH, Lilly Diabetes, Merck Sharp & Dohme Corp., Novo Nordisk, Sanofi-Aventis Deutschland GmbH, Tandem Diabetes Care, Inc., Research Support; Medtronic. C.Thivolet: Board Member; Insulet Corporation, Medtronic, Research Support; Abbott Diabetes, Lilly Diabetes, Novo Nordisk A/S, Sanofi. M.Evans: Advisory Panel; Pila Pharma, Zucara Therapeutics, Other Relationship; Abbott Diabetes, Dexcom, Inc., Medtronic, Novo Nordisk, Research Support; AstraZeneca, Sanofi, Speaker's Bureau; Lilly Diabetes. R.Ré: Employee; Medtronic. L.Vorrink de groot: Employee; Medtronic. J.Shin: Employee; Medtronic. A.Habteab ghebretinsae: None.



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