199-OR: Improved Glycemic Outcomes with Medtronic Minimed Advanced Hybrid Closed-Loop Delivery: Results from a Randomized Crossover Trial Comparing Automated Insulin Delivery with Predictive Low Glucose Suspend in People with Type 1 Diabetes

Background: The Medtronic Minimed® Advanced Hybrid Closed-Loop system (AHCL) includes an individualised algorithm with optional set points, automated correction bolus, and improved SmartGuard™ Auto Mode stability. Methods: This dual-centre, randomized, open-label, two-sequence cross-over study in automated insulin delivery naïve participants (aged 7-80yrs), compared AHCL to Sensor Augmented Pump therapy with Predictive Low Glucose Management (SAP+PLGM). Each study phase was 4 weeks, preceded by a 2-4 week run-in, and separated by 2-week washout. Results: 59/60 people completed the study (mean age 23.3±14.4yrs). Overall time in target range (TIR) (70-180mg/dL) favoured AHCL over SAP+PLGM by 12.5±8.5% (p180mg/dL). Mean SG improved in AHCL by 10.0±7.4mg/dL (p Conclusion: AHCL with automated correction bolus showed significant improvement in glucose control compared to PLGM, in a population with a younger mean age reflecting a challenging demographic. Disclosure O. Collyns: None. R. Meier: None. Z. Betts: None. D. Chan: None. C. Frampton: None. C.M. Frewen: None. B. Grosman: Employee; Self; Medtronic. N. Hewapathirana: Other Relationship; Self; Sanofi. S. Jones: None. N. Kurtz: Employee; Self; Medtronic. A. Roy: Employee; Self; Medtronic. J. Shin: Employee; Self; Medtronic. R. Vigersky: Employee; Self; Medtronic. B.J. Wheeler: Research Support; Self; Medtronic. M. de Bock: None.