MiniMed 780G Advanced Hybrid Closed-Loop System Use During Days Without User-Initiated Boluses

OBJECTIVE: To evaluate glycemic metrics and insulin delivery during real-world use of the MiniMed 780G (MM780G) system on days when users did not administer boluses. RESEARCH DESIGN AND METHODS: Global CareLink personal data of consenting MM780G users (N = 369,467) uploaded from 2 January 2020 to 31 March 2025 were analyzed. Among these individuals, 54,553 users experienced ≥10 days without any user-initiated boluses. Evaluated key metrics included time in range (TIR; 70-180 mg/dL), time below range (TBR; 180 mg/dL), the glucose management indicator (GMI), and total insulin delivered. These were analyzed for the overall population who did not initiate boluses and for those who used and did not use recommended optimal settings (ROS; defined as a 100 mg/dL glucose target and a 2-h active insulin time). Subgroup analyses were conducted by age (≤15 or >15 years) and diabetes type (type 1 or 2). RESULTS: On days when boluses were missed, ROS users had a mean sensor glucose (SG) of 149.2 mg/dL, with mean TIR, TBR, and GMI of 76.3%, 0.8%, and 6.9%, respectively, whereas non-ROS users had a mean SG of 159.7 mg/dL with mean TIR, TBR, and GMI of 69.3%, 0.9%, and 7.1%, respectively. ROS use was associated with more individuals achieving consensus TIR, TBR, and GMI goals. CONCLUSIONS: These data demonstrate effective glycemic control with the MM780G system on days when some users did not initiate boluses. A greater proportion of real-world users achieved glycemic goals when ROS were used.