Excellence in the management of Advanced Hybrid Closed-Loop Systems: Lessons from the Polish cohort.

Background: The aim of the study was to analyze the real-world performance of MiniMed 780G (MM780G) Advanced Hybrid Closed Loop (AHCL) system users from Poland (PL) and compare it to the European region excluding Poland (EU-PL) in order to identify factors contributing to potential differences. The former achieved some of the best Time in Range (TIR) results globally using this technology.
Methods: CareLink Personal data uploaded by MM780G system users from August 2020 to December 2022 were analyzed.
Results: The Polish users (N=1304) on average reached to TIR of 79.1 ± 8.7 % (vs 73.0 ± 10.0 % for EU-PL, N=55659), a TBR<54 mg/dL of 0.6 ± 0.7 % (vs 0.4 ± 0.6 %) and a TBR<70 mg/dL of 2.9 ± 2.1 % (vs 2.1 ± 1.8 %). The adoption rate of optimal settings (i.e, GT=100 mg/dL, AIT=2hr) in PL was high (19.7 % vs 6.3 %), and filtering on optimal setting users led to less pronounced differences in glycemic control between PL and EU-PL. A univariable analysis with post-AHCL TIR showed that geography itself (PL vs EU-PL) is not a significant contributor to a high post-AHCL TIR (p = 0.15), and that much of the Polish post-AHCL TIR can be explained by the high pre-AHCL TIR.
Conclusion: The Polish MM780G users achieved better glycemic control than the general European population (excluding Poland). This is largely attributable to the adoption of optimal settings in Poland and the already high glycemic outcomes at system start. As these characteristics can be implemented elsewhere, we believe this outstanding result can be obtained in other countries as well.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Bartłomiej Matejko, Tim van den Heuvel, Javier Castaneda, Arcelia Arrieta, Katarzyna Cyranka, Ohad Cohen, Maciej Małecki, Tomasz Klupa; Duality of Interest. JC, AA, TH, and OC are employees of Medtronic Europe. MM, TK – cooperation with Medtronic company: lectures, scientific support Advisory Board. BM, KC: cooperation with Medtronic company: lectures].
(Copyright © 2024. Published by Elsevier B.V.)