Time in Tight Glucose Range in Type 1 Diabetes: Predictive Factors and Achievable Targets in Real-World Users of the MiniMed 780G System
Open accessAbstract
OBJECTIVE: We studied time in tight range (TITR) (70–140 mg/dL) in real-world users of the MiniMed 780G system (MM780G). RESEARCH DESIGN AND METHODS: CareLink Personal data were extracted (August 2020 to December 2022) to examine TITR and its relationship with time in range (TIR; 70–180 mg/dL), factors predicting higher TITR, and which TITR target is a reasonable treatment goal. RESULTS: The 13,461 users (3,762 age ≤15 years and 9,699 age >15 years) showed an average TITR of 48.9% in those age ≤15 years and 48.8% in the older group (vs. TIR 71.2% and 73.9%, respectively). Consistent use of a glucose target (GT) of 100 mg/dL and active insulin time (AIT) of 2 h were the most relevant factors predicting higher TITR (P < 0.0001). In users consistently applying these optimal settings, TITR was 56.7% in those age ≤15 years and 57.0% in the older group, and the relative impact of these settings on TITR was 60% and 86% greater than that on TIR, respectively. TITRs of ∼45% (age ≤15 years 46.3% and older group 45.4%), ∼50% (50.7% and 50.7%) and ∼55% (56.4% and 58.0%) were best associated with glucose management indicators <7.0%, <6.8%, and <6.5%, respectively. TITRs of >45%, >50%, and >55% were achieved in 91%, 74%, and 55% of those age ≤15 years and 93%, 81%, and 57% of older group users, respectively, at optimal settings. CONCLUSIONS: This study demonstrates 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.
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Real-world data also aligned with clinical trial outcomes showing HbA1c reductions of 0.3-0.7% across diverse age groups.
“Realworld data also aligned with clinical trial outcomes showing HbA₁ c reductions of 0•3-0•7% across diverse age groups.95,101,102”
From The future of type 1 diabetes therapy (2025) · cites this paper as [102]
The Results (Part 1; page not provided) report real-world GMI reductions of 0.4% in users aged ≤15 years and 0.3% in older users. The Conclusions say these improvements were consistent with clinical studies, but also state that HbA1c could not be used as an endpoint. This source therefore supports improvement across age groups, not the attributed 0.3–0.7% HbA1c reduction. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe observed results are similar to earlier AID clinical investigations, demonstrating comparable performance in percent time in range to Control-IQ (70.9%), Omnipod 5 (67.8%), and Medtronic 780G (71.2% ≤15 years/73.9% >15 years).
“Despite the small cohort, our findings are similar to earlier AID clinical investigations, demonstrating comparable performance in %TIR observed in prospective and retrospective observation trials of other systems, such as Control-IQ (70.9%),15 Omnipod 5 (67.8%),16 and Medtronic 780G (71.2% (≤15 years)/73.9% (>15 years)).17”
From Clinical utility of the twiist Automated Insulin Delivery System: first study with twiist (2026) · cites this paper as [17]
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Cites
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The fallacy of average: how using HbA1c alone to assess glycemic control can be misleading
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The future of type 1 diabetes therapy
Ziegler, A.-G., Cengiz, E., & Kay, T. W. H. (2025) · The Lancet · doi:10.1016/s0140-6736(25)01438-2 · Cited by 42 · see citing works
Clinical utility of the twiist Automated Insulin Delivery System: first study with twiist
Ruiz, A., Mcdonough, A., Snow, K., Bode, B., & Mitri, J. (2026) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2026-006307
- Authors
- Castañeda, J., Arrieta, A., van den Heuvel, T., Battelino, T., & Cohen, O.
- Affiliations
- Medtronic (Switzerland) (CH)
- 1Medtronic International Trading Sàrl, Tolochenaz, Switzerland
- University of Ljubljana (SI)
- Corresponding author
- Cohen, Ohad
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2023-12-19
- Volume
- 47
- Issue
- 5
- Pages
- 790-797
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC11043222
- OpenAlex
- W4389942708
- Cited by
- 107
- References
- 8
- Citations by year
- 2026: 31 · 2025: 45 · 2024: 31
- FWCI
- 21.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Medtronic Europe
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- type 1 diabetes, time in tight range, MiniMed 780G, glycemic targets, time in range, glucose management indicator, predictive factors, treatment goals, adolescents, adults, glycemic control, hypoglycemia, hyperglycemia, continuous glucose monitoring, insulin dose
- MeSH terms
- Adolescent, Blood Glucose, Diabetes Mellitus, Type 1, Glucose, Humans, Hypoglycemic Agents, Insulin, Blood Glucose Self-Monitoring
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