Real-world glycaemic outcomes observed with the use of Medtronic 780G, Tandem Control-IQ and Omnipod 5 automated insulin delivery systems

Abstract

Background: No randomised controlled trials have directly compared commercially available hybrid automated insulin delivery (AID) systems, and real-world comparative data remain limited. This study evaluated glycaemic outcomes across three hybrid AID systems in adults with type 1 diabetes (T1D). Methods: This was a retrospective, observational, single-centre study and included adults with T1D who transitioned from multiple daily injections (MDI) or non-automated insulin pump therapy to hybrid AID. Data were collected from routinely used clinical data-sharing platforms and electronic health records. Outcomes compared across systems included time in range (TIR; 3.9–10.0 mmol/L), time below range (TBR; <3.9 and <3.0 mmol/L), time above range (TAR; >10.0 and >13.9 mmol/L), glucose management indicator (GMI, %) and coefficient of variation (CV, %). Results: A total of 213 participants were included (Medtronic 780G n = 38; Tandem Control-IQ n = 81; Omnipod 5 n = 94). After adjustment for baseline TIR, diabetes duration, insulin modality and AID use duration 780G users achieved a higher TIR increase (21.1% [95% CI 18.4–23.7]) compared to Control-IQ (10.1% [3.2–17.3], p = 0.010) and Omnipod 5 (15.2% [12.9–17.5], p = 0.002), with corresponding reductions in TAR. Conclusion: All three hybrid AID systems were associated with improvements in glycaemic outcomes in real-world use, supporting the role of AID systems in the management of T1D. Medtronic 780G use was associated with higher TIR increase compared with the other systems; however, these findings are based on measurements from different continuous glucose monitors between AID groups and cannot be used to infer superiority in glycaemic attainment.