A systematic review and meta-analysis of a dozen trials assessing the MiniMed 670G system provides insight into the effects of the hybrid closed-loop system on A1c and time in range among patients with type 1 diabetes.
New research presented at the American Academy of Clinical Endocrinology’s 30th Annual Meeting (AACE 2021) is detailing the effect of Medtronic’s MiniMed 670G system on change in HbA1c and time in range in patients with type 1 diabetes.
A systematic review and meta-analysis of data from major databases included a dozen studies and determined Auto Mode use results in an A1c change of -0.5% and a nearly 10% increase in time in range.
“This meta-analysis of MiniMed™ 670G Auto Mode therapy use compared with other therapies showed a significant improvement in glycemic control. These comprehensive findings demonstrate a safe and clinically meaningful impact of a first-of-its-kind device for T1D management,” wrote investigators.
With approval coming from the US Food and Drug Administration in 2016, the MiniMed 670G system became the first hybrid closed-loop insulin delivery system approved anywhere in the world. Designed for use in patients with type 1 diabetes, the device represented a revolution in care and has found its way into the care of many with type 1 diabetes.
Presented at AACE 2021 by Toni Cordero, PhD, of Medtronic, the current study was designed as a systematic review and meta-analysis of trials examining use of the MiniMed 670G Auto Mode therapy versus a comparator for effect on A1c and time in range. Performing a search of the Embase, PubMed, and Web of Science databases returned 127 articles, of which 12 met the investigators’ inclusion criteria.
Of the 12 trials identified for inclusion, all 12 reported on change in A1c, 11 reported data on time in range, and 9 reported on time below range. Additionally, investigators noted 10 trials investigated the MiniMed 670G in Auto Mode versus open-loop Manual Mode therapy, one assessed Auto Mode against multiple daily injections with CGM, and another compared Auto Mode versus sensor-augmented pump therapy.
Upon analysis, results indicated there was a significant reduction in mean difference in A1c (MD, -0.50; 95% CI, -0.59 to -0.42) between the pre- and post-Auto Mode intervention and significant heterogeneity was also noted (I2=70%). Investigators noted a significant gain in time in range between the pre- and post-Auto Mode intervention, with significant heterogeneity in study estimates. Additionally, investigators also pointed there was a significant reduction in time blow range (MD, -0.21; 95% CI, -0.33 to -0.10) and significant heterogeneity was observed in study estimates (I2=64%).
“Analysis demonstrated a reduction in A1C and an increase in TIR with Auto Mode use, suggesting a benefit in terms of glycemic control. Significant variation in reported estimates, likely due to differing protocols across the various studies, indicate that a more standardized protocol for closed-loop system trials may reduce heterogeneity,” wrote investigators.
This study, “Systematic review and meta-analysis of MiniMed™ 670G system therapy on change in A1C and time spent in target glucose range,” was presented at AACE 2021.