Impact of training type (virtual vs in-person) on long-term glycemic control in people with type 1 diabetes using minimed 780: A non-inferiority longitudinal study
Ana María Gómez Medina, Diana Cristina Henao-Carrillo, Oscar Muñoz, María Lorena Alfonso-Pisco, Felipe CabezasBackground
Information on the long-term effect of a virtual educational program compared to in-person training for advanced closed-loop hybrid (AHCL) system users is limited.
Objective
To evaluate whether virtual training is no inferior to face-to-face training with respect to long-term glycemic control in adults with type 1 diabetes (T1D) who use the MiniMed™ 780G system.
Desing
Longitudinal study based on historical cohorts of adult patients with T1D using the MiniMed™ 780G system followed during 180 days.
Methods
One cohort was trained in person and the other virtually at Hospital Universitario San Ignacio in Bogotá, Colombia. Continuous glucose monitoring metrics were analyzed at days 0, 14, 90, and 180. Generalized estimating equations (GEE) were applied to evaluate the impact of type of training and different confounding variables on the change of time in range (TIR) over time.
Results
A total of 181 patients were included (49.8% trained virtually; median age 39 years, median baseline HbA1c 7.5%). Both groups showed a significant improvement in TIR from baseline to day 14, which remained stable until day 180. In the adjusted GEE model, the between-group difference in TIR for virtual versus face-to-face training was 0.53% (95% CI -2.32 to 3.40; p=0.714), which remained within the prespecified non-inferiority margin. Proper sensor use (p=0.003) and optimal system configuration (p=0.004) were associated with better glycemic control. Higher HbA1c was associated with lower TIR.
Conclusion
Virtual training was non inferior to face-to-face training for initiating treatment with MiniMed™ 780G in adults with T1D. Virtual training is a viable and effective strategy to expand access to education in settings with logistical or geographical barriers.