Automated insulin delivery systems: Advancements and future prospects

Mary Ann Liebert Inc.Feb 23 2024

A special 13-article supplement to the peer-reviewed journal Diabetes Technology & Therapeutics (DTT) examines the "Development and Future of Automated Insulin Delivery (AID) Systems. 

Included in the supplement is the article titled "A Peek Under the Hood: Explaining the MiniMed™ 780G Algorithm with Meal Detection™ Technology", by Benyamin Grosman, PhD and his Medtronic algorithm team with co-authors Ohad Cohen, MD, and Robert Vigersky, MD, Chief Medical Officer at Medtronic. James Thrasher, MD "Early Real-World Performance of the MiniMed™ 780G Advanced Hybrid Closed-Loop System and Recommended Settings Use in the United States" demonstrating higher time-in-range and low time-below range that is similar to that found in other parts of the world and documented by Pratik Choudhary, MBBS "Celebrating the Data from 100,000 Real-World Users of the MiniMed 780G System in Europe, Middle East and Africa Collected over 3 Years: From Data to Clinical Evidence"

Diana Isaacs, PharmD, from the Cleveland Clinic Diabetes Center, and coauthors contributed the article titled "Removing Barriers, Bridging the Gap and the Changing Role of the HCP with AID Systems." Chantal Mathieu MD, PhD and colleagues from Leuven Belgium and Asli Zeynep Ozdemir Saltik highlight "The Health Economics of Automated Insulin Delivery Systems and the Use of Time in Range in Diabetes Modeling: A Narrative Review".

Also featured in this Supplement is a 3-continent international collaboration from David O'Neal, MD and Dale Morrison, PhD from the University of Melbourne, Desi Zaharieva, PhD from Stanford University and Olivia McCarthy, PhD, and Kirsten Nørgaard, MD, from Copenhagen University and Steno Diabetes Center is the article titled "Exercising Safely with the MiniMed 780G Automated Insulin Delivery System". Greg Forlenza, MD and John Shin, PhD objectively assess how the burden of diabetes management are reduced with the use of the 780G system in the article titled "Reducing Diabetes Burden in Medtronic's Automated Insulin Delivery (AID) Systems".

Jennifer Sherr, MD, PhD and Elizabeth Considine, BS from Yale University review the growing literature on real-world evidence of automated insulin delivery devices in the article titled "Real-world Evidence of Automated Insulin Delivery System Use" finding that they confirm pivotal trial results. 

Robert Vigersky, MD also contributes an article questioning the common use of MARD to characterize the accuracy of a CGM titled "The Myth of MARD: Limitations of MARD in the Clinical Assessment of Continuous Glucose Monitoring Data". Finally, Bruce Buckingham, MD, from Stanford University School of Medicine, and Richard Bergenstal, MD, Executive Director of the International Diabetes Center, co-authored an instructive case study titled "Decreasing the Burden of Carbohydrate Counting and Meal Announcement with Automated Insulin Delivery (AUD), Meal Recognition, and Autocorrection Doses: A Case Study".

"Hybrid Closed-Loop (HCL or AID) Systems have significantly evolved over the past 10 years. The current AID systems not only reduce hypoglycemia especially overnight but also improve overall glucose control and time in range (TIR) beyond 70% and thus reducing diabetes burden. The current 780G system allows lowest target range setting to 100 mg/dl and delivers mini-boluses every 5-minute based on the sensor glucose values," says Satish Garg, MD, Editor-in-Chief of Diabetes Technology & Therapeutics, from the University of Colorado Denver, Barbara Davis Center for Diabetes.