A Multicenter Prospective Evaluation of the Benefits of Two Advanced Hybrid Closed-Loop Systems in Glucose Control and Patient-Reported Outcomes in a Real-world Setting
Advanced hybrid closed-loop systems (AHCL) have been shown to improve glycemic control and patient-reported outcomes in type 1 diabetes. The aim was to analyze the outcomes of two commercially available AHCL in real life. A prospective study was performed, including adolescents and adults with type 1 diabetes, AHCL naïve, from 14 centers, who initiated the use of MiniMed 780G with SmartGuard or Tandem t:slimX2 with Control-IQ. Baseline and 3-month evaluations were performed, assessing HbA1c, time in different glycemic ranges, and patient-reported outcomes. The primary outcome was the between-group time in range 70–180 mg/dL difference from beginning to end of follow-up. Time in range increased from 61.53 to 76.17 , with no between-group differences. HbA1c decreased by 0.56%, , from 7.43 to 6.88. in the MiniMed 780G group, and from 7.14 to 6.56 in the Control-IQ group. No superiority of one AHCL over the other regarding fear of hypoglycemia or quality of life was found. Improvement in diabetes-related distress was higher in Control-IQ users. Sleep quality was improved, without differences between systems. Experience with AHCL, evaluated by the INSPIRE measures, exceeded the expectations.