Long‐term effectiveness of advanced hybrid closed loop in children and adolescents with type 1 diabetes

Background Advanced hybrid closed loop (AHCL) systems are the newest tool to improve metabolic control in type 1 diabetes (T1D). Long‐term glycemic control of children and adolescents with T1D switching to MiniMed™ 780G in a real clinical setting was evaluated. Methods Time in range (TIR) and in different glucose ranges, glycemic variability indexes, HbA1c and basal‐bolus insulin distribution were evaluated in 44 subjects (mean age 14.2 ± 4.0 years, 22 males) during manual mode period, first 14 days (A14d) and first month after auto‐mode activation (A1M), first 14 days after 3 months (A3M) and 6 months (A6M) in auto‐mode. Results Mean TIR at A14d was 76.3 ± 9.6% versus 69.3 ± 12.6% in manual mode (p 70% and >80% in manual mode were 45% and 23%, respectively, and increased to 80% (p = 0.041) and 41% (p = 0.007) at A14d. Basal‐bolus distribution changed in favor of bolus, and auto‐correction boluses inversely correlated with TIR. HbA1c was 7.2 ± 0.7% (55 mmol/mol) at baseline and significantly improved after 3 months (6.7 ± 0.5%, 50 mmol/mol, p