P-152: Improved time in range and glycated haemoglobin after switching between advanced hybrid closed loop systems in children and young people with type 1 diabetes at an NHS foundation trust in the UK
R Swindell, E Bateman, R F Pollock, J Smith-Palmer, , U. Hospitals of Derby and Burton Paediatric Diabetes TeamAbstract
Introduction
Advanced hybrid closed-loop (AHCL) insulin delivery systems are increasingly used in paediatric patients with type 1 diabetes (T1D), but comparative real-world data on outcomes after switching between systems remain limited.
Objectives
To evaluate glycaemic outcomes in children and young people with T1D at the University Hospitals of Derby and Burton NHS Foundation Trust who switched from OmniPod 5 to the MiniMed 780G AHCL system because of challenges meeting glycaemic control targets.
Methods
A retrospective analysis was conducted in all patients who switched from OmniPod 5 to the MiniMed 780G AHCL system. Glycated haemoglobin (HbA1c) levels, time in range (TIR; blood glucose levels 3.9–10.0 mmol/L or 70–180 mg/dL), and coefficients of variation (CV) were compared before and at least 3 months after switch.
Results
A total of 32 patients were identified. Mean TIR improved from 54.4% at the last visit using OmniPod 5 to 68.3% at the first visit after switching to MiniMed 780G in 29 patients for whom data were available at both time points, corresponding to an absolute improvement of 13.9%-points. Improvements in TIR were observed in 26 of the 29 patients (Figure). In the 22 patients for whom HbA1c measurements were available before and after switching, HbA1c decreased from 62.3 mmol/mol (7.85%) prior to switching to an average of 59.5 mmol/mol (7.6%) after switching. The proportion of patients with a CV <43.4% increased from 67% (20/30) before switching to 87% (26/30) after switching. Together, these outcomes suggest a clinically meaningful improvement in glycaemic control after switching to the MiniMed 780G AHCL system.
Conclusions
In this real-world cohort, switching from the OmniPod 5 to the MiniMed 780G AHCL system was associated with improvements in TIR, HbA1c and CV. Larger, prospective studies with additional glycaemic and patient-reported outcomes would be warranted to confirm these findings.