Time in tight glucose range in type 1 diabetes - predictive factors and achievable targets in real-world users of the MiniMed 780G system

Introduction: We studied time in tight range (TITR, 70-140mg/dL) in real-world users of the MiniMed 780G system (MM780G). Methods: CareLink Personal data were extracted (Aug2020-Dec2022) to examine TITR and its relationship with time in range (TIR, 70-180mg/dL), to examine factors predicting higher TITR, and to examine which TITR target was a reasonable treatment goal. Results: The 13,461 users (3,762 £15yrs, 9,699 >15yrs) showed an average TITR of 48.9% in £15yrs and 48.8% in the older group (vs. TIR=71.2% and 73.9%). Consistent use of ‘glucose target (GT)=100mg/dL’ and ‘active insulin time (AIT)=2hrs’ were most relevant factors predicting higher TITR (p<0.0001). In users consistently applying these optimal settings, TITR was 56.7% in £15yrs and 57.0% in the older group, and the relative impact of these settings to TITR was 60% and 86% larger than to TIR, respectively. A TITR of ~45% (£15yrs: 46.3%, older group: 45.4%), ~50% (50.7%, 50.7%) and ~55% (56.4%, 58.0%) best associated with GMI<7.0%, <6.8% and <6.5%. A TITR of >45%, >50% and >55% was achieved in 91%, 74% and 55% of £15yrs and 93%, 81%, and 57% of older group users on optimal settings. Conclusion: This study demonstrated that (1) mean TIR is high with a high mean TITR in MM780G users (>48%), (2) consistent use of optimal GT/AIT improves TITR (>56%), (3) the impact of these settings on TITR is larger than on TIR and (4) a TITR target >50% is our suggested treatment goal.