Time in Tight Range in AHCL Systems: Propensity-Score-Matched Analysis of MiniMed 780G and Control-IQ

Background: Advanced hybrid closed-loop (AHCL) systems have improved the glycemic control in type 1 diabetes (T1D). While time in range (TIR) (70–180 mg/dL) is the standard metric, time in tight range (TITR) (70–140 mg/dL) offers a stricter assessment. Real-world comparisons using the TITR are limit...

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Main Authors: María Sara Tapia Sanchiz, Victor Navas-Moreno, Fernando Sebastián Valles, Juan José Raposo López, Carolina Sager La Ganga, Elena Carrillo López, Sara González Castañar, Selma Amar, Marcos Lahera Vargas, Jose Alfonso Arranz Martín, Mónica Marazuela
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Diabetology
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Online Access:https://www.mdpi.com/2673-4540/6/7/69
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author María Sara Tapia Sanchiz
Victor Navas-Moreno
Fernando Sebastián Valles
Juan José Raposo López
Carolina Sager La Ganga
Elena Carrillo López
Sara González Castañar
Selma Amar
Marcos Lahera Vargas
Jose Alfonso Arranz Martín
Mónica Marazuela
author_facet María Sara Tapia Sanchiz
Victor Navas-Moreno
Fernando Sebastián Valles
Juan José Raposo López
Carolina Sager La Ganga
Elena Carrillo López
Sara González Castañar
Selma Amar
Marcos Lahera Vargas
Jose Alfonso Arranz Martín
Mónica Marazuela
author_sort María Sara Tapia Sanchiz
collection DOAJ
description Background: Advanced hybrid closed-loop (AHCL) systems have improved the glycemic control in type 1 diabetes (T1D). While time in range (TIR) (70–180 mg/dL) is the standard metric, time in tight range (TITR) (70–140 mg/dL) offers a stricter assessment. Real-world comparisons using the TITR are limited. This study compared the TIR and TITR metrics between the MiniMed™ 780G and Tandem Control-IQ™ in adults with T1D. Methods: This retrospective, single-center study included 42 propensity-score-matched adults with T1D (28 MM780G users and 14 Tandem Control-IQ users), each with ≥3 months of AHCL system use. Glycemic metrics from continuous glucose monitoring (CGM) were analyzed over a 14-day period. Comparisons between groups were conducted using Mann–Whitney U tests, adjusted linear regression, and linear mixed-effects models accounting for repeated measures. Results: At three months, the MM780G users achieved significantly higher TITR (60.1% ± 12 vs. 49.5% ± 9.3; <i>p</i> = 0.005) and TIR (83.7% ± 7.6 vs. 72.1% ± 7.5; <i>p</i> < 0.001) values, along with lower glucose variability, compared to these values in the Tandem Control-IQ users. The linear regression model confirmed that the MM780G was independently associated with a higher TITR (β = 14.2; <i>p</i> = 0.005). Mixed-effects modeling for the TIR showed a significant interaction between timepoint and device type (β = 4.81; <i>p</i> = 0.006), favoring the MM780G. Conclusions: In this real-world analysis, both AHCL systems improved glycemic control, but the MiniMed 780G could be associated with a superior performance in achieving tighter glucose targets without increasing hypoglycemia. TITR may serve as a valuable complementary metric alongside TIR in evaluating AHCL systems’ effectiveness. However, these findings should be interpreted cautiously due to limitations such as the retrospective design, small sample size, potential residual confounding, and lack of standardization in the device settings. Further studies are warranted to confirm these results and assess their generalizability.
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publisher MDPI AG
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series Diabetology
spelling doaj-art-6cf6f8cf587e4068bf214439501471932025-08-20T03:32:31ZengMDPI AGDiabetology2673-45402025-07-01676910.3390/diabetology6070069Time in Tight Range in AHCL Systems: Propensity-Score-Matched Analysis of MiniMed 780G and Control-IQMaría Sara Tapia Sanchiz0Victor Navas-Moreno1Fernando Sebastián Valles2Juan José Raposo López3Carolina Sager La Ganga4Elena Carrillo López5Sara González Castañar6Selma Amar7Marcos Lahera Vargas8Jose Alfonso Arranz Martín9Mónica Marazuela10Department of Endocrinology and Nutrition, Hospital Universitario de la Princesa, Calle de Diego de León, 62, 28006 Madrid, SpainDepartment of Endocrinology and Nutrition, Hospital Universitario de la Princesa, Calle de Diego de León, 62, 28006 Madrid, SpainDepartment of Endocrinology and Nutrition, Hospital Universitario de la Princesa, Calle de Diego de León, 62, 28006 Madrid, SpainDepartment of Endocrinology and Nutrition, Hospital Universitario de la Princesa, Calle de Diego de León, 62, 28006 Madrid, SpainDepartment of Endocrinology and Nutrition, Hospital Universitario de la Princesa, Calle de Diego de León, 62, 28006 Madrid, SpainDepartment of Endocrinology and Nutrition, Hospital Universitario de la Princesa, Calle de Diego de León, 62, 28006 Madrid, SpainDepartment of Endocrinology and Nutrition, Hospital Universitario de la Princesa, Calle de Diego de León, 62, 28006 Madrid, SpainDepartment of Endocrinology and Nutrition, Hospital Universitario de la Princesa, Calle de Diego de León, 62, 28006 Madrid, SpainDepartment of Endocrinology and Nutrition, Hospital Universitario de la Princesa, Calle de Diego de León, 62, 28006 Madrid, SpainDepartment of Endocrinology and Nutrition, Hospital Universitario de la Princesa, Calle de Diego de León, 62, 28006 Madrid, SpainDepartment of Endocrinology and Nutrition, Hospital Universitario de la Princesa, Calle de Diego de León, 62, 28006 Madrid, SpainBackground: Advanced hybrid closed-loop (AHCL) systems have improved the glycemic control in type 1 diabetes (T1D). While time in range (TIR) (70–180 mg/dL) is the standard metric, time in tight range (TITR) (70–140 mg/dL) offers a stricter assessment. Real-world comparisons using the TITR are limited. This study compared the TIR and TITR metrics between the MiniMed™ 780G and Tandem Control-IQ™ in adults with T1D. Methods: This retrospective, single-center study included 42 propensity-score-matched adults with T1D (28 MM780G users and 14 Tandem Control-IQ users), each with ≥3 months of AHCL system use. Glycemic metrics from continuous glucose monitoring (CGM) were analyzed over a 14-day period. Comparisons between groups were conducted using Mann–Whitney U tests, adjusted linear regression, and linear mixed-effects models accounting for repeated measures. Results: At three months, the MM780G users achieved significantly higher TITR (60.1% ± 12 vs. 49.5% ± 9.3; <i>p</i> = 0.005) and TIR (83.7% ± 7.6 vs. 72.1% ± 7.5; <i>p</i> < 0.001) values, along with lower glucose variability, compared to these values in the Tandem Control-IQ users. The linear regression model confirmed that the MM780G was independently associated with a higher TITR (β = 14.2; <i>p</i> = 0.005). Mixed-effects modeling for the TIR showed a significant interaction between timepoint and device type (β = 4.81; <i>p</i> = 0.006), favoring the MM780G. Conclusions: In this real-world analysis, both AHCL systems improved glycemic control, but the MiniMed 780G could be associated with a superior performance in achieving tighter glucose targets without increasing hypoglycemia. TITR may serve as a valuable complementary metric alongside TIR in evaluating AHCL systems’ effectiveness. However, these findings should be interpreted cautiously due to limitations such as the retrospective design, small sample size, potential residual confounding, and lack of standardization in the device settings. Further studies are warranted to confirm these results and assess their generalizability.https://www.mdpi.com/2673-4540/6/7/69type 1 diabeteshybrid closed-loop systemsMiniMed 780GTandem Control-IQtime in tight range (TITR)time in range (TIR)
spellingShingle María Sara Tapia Sanchiz
Victor Navas-Moreno
Fernando Sebastián Valles
Juan José Raposo López
Carolina Sager La Ganga
Elena Carrillo López
Sara González Castañar
Selma Amar
Marcos Lahera Vargas
Jose Alfonso Arranz Martín
Mónica Marazuela
Time in Tight Range in AHCL Systems: Propensity-Score-Matched Analysis of MiniMed 780G and Control-IQ
Diabetology
type 1 diabetes
hybrid closed-loop systems
MiniMed 780G
Tandem Control-IQ
time in tight range (TITR)
time in range (TIR)
title Time in Tight Range in AHCL Systems: Propensity-Score-Matched Analysis of MiniMed 780G and Control-IQ
title_full Time in Tight Range in AHCL Systems: Propensity-Score-Matched Analysis of MiniMed 780G and Control-IQ
title_fullStr Time in Tight Range in AHCL Systems: Propensity-Score-Matched Analysis of MiniMed 780G and Control-IQ
title_full_unstemmed Time in Tight Range in AHCL Systems: Propensity-Score-Matched Analysis of MiniMed 780G and Control-IQ
title_short Time in Tight Range in AHCL Systems: Propensity-Score-Matched Analysis of MiniMed 780G and Control-IQ
title_sort time in tight range in ahcl systems propensity score matched analysis of minimed 780g and control iq
topic type 1 diabetes
hybrid closed-loop systems
MiniMed 780G
Tandem Control-IQ
time in tight range (TITR)
time in range (TIR)
url https://www.mdpi.com/2673-4540/6/7/69
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