Improvement of Care & Outcome


Dick Mul, Arcelia Arrieta, Pim Dekker, Henk-Jan Aanstoot, Martine de Vries, Theo Sas, Henk Veeze

Increased time in range and sustained Auto Mode use in 670G hybrid closed-loop system users: real world experience in DIABETER. 13th International Conference on Advanced Technologies and Treatments for Diabetes, 19-22 February 2020, Madrid, Spain. Abstract: #170.

In recent years the advances in technology, including Medtronic’s 670G hybrid closed-loop (HCL) system, have considerably widened the spectrum of treatment options in type 1 diabetes. Time in Auto Mode (automated basal insulin delivery, based on CGM data) is a crucial factor for success of the 670G HCL system. In a recent study the time in Auto Mode decreased from 74% to 35% in the first year after starting on the 670G HCL system. At Diabeter we have introduced the 670G HCL system by providing a comprehensive and structured education and follow-up program. The aims of this real-word data analysis were to 1) assess if our introduction program helps patients to maintain the appropriate percentage of time spent in Auto Mode and 2) to assess glucose metrics after start on the 670G system.


We included people with type 1 diabetes on either pump or MDI (with or without glucose sensor monitoring) who switched to the 670G system for clinical reasons and/or patient preference anddescriptively analysed data from 1-10-2018 until 1-12-2019. The percentage time in Auto Mode was calculated at 1, 3, 6, 9 and 12 months after start on the 670G HCL system. Glucose metrics (time below range [TBR: <3.9 mmol/L], time in range [TIR: 3.9 – 10 mmol/L] and time above range [TAR: >10 mmol.L]) were also calculated.


Key findings: 

  • During the analysed time period 77 patients were included (age [SD], 20.1 [10.2] years; diabetes duration [SD], 11.8 [8.4] years, gender [% male], 49.4%).
  • HbA1c was 7.0 (0.7)%.
  • Median percentage time in Auto Mode remained relatively constant at 84-93%
  • TIR increased after switching to Auto Mode, while TBR and TAR decreased 

Our analysis shows that after starting on the 670G HCL system the percentage time in Auto Mode is sufficient and sustained over time, as opposed to recently reported results. In addition, this results in consistently improved glucose metrics, compared with the pre-Auto Mode situation, and is consistent with ranges specified by international guidelines. We hypothesize that our comprehensive education and follow-up program helps patients to stay in the Auto mode and thus facilitates optimal use of the 670G HCL system.


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