{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:37:28Z","timestamp":1790775448252,"version":"4.1.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology &amp; Therapeutics"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To evaluate the long-term efficacy, up to 2 years, of an advanced hybrid closed-loop (AHCL) system and to assess predictors of best results of the therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We retrospectively evaluated 296 adults with type 1 diabetes mellitus [mean age 42.8\u2009\u00b1\u200916.5 years, men 42.9%, duration of diabetes 22.5\u2009\u00b1\u200912.8 years, body mass index 24.9\u2009\u00b1\u20094.7\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , baseline glycated hemoglobin (HbA\n                      <jats:sub>1c<\/jats:sub>\n                      ) 63.4\u2009\u00b1\u200912.2\u2009mmol\/mol (8.0\u2009\u00b1\u20091.1%) ] who used the MiniMed\u2122 780G system. Demographic and clinical data were recorded. Continuous glucose monitoring (CGM)-derived metrics and insulin requirement were analyzed from the 4 weeks before and from every quarter after the switch to the AHCL system.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In the first quarter of AHCL treatment, all CGM metrics improved. Time in range (TIR) increased from 58.1\u2009\u00b1\u200917.5% to 70.3\u2009\u00b1\u20099.5% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.0001). The improvement lasted for up to 2 years of observation regardless of previous insulin therapies. Throughout the period of observation, 53.4% of participants achieved mean TIR &gt;70%, 92.6% mean time below range &lt;4%, and 46% mean glucose management indicator &lt;53\u2009mmol\/mol (7.0%). At univariable logistic regression older age, lower baseline HbA\n                      <jats:sub>1c<\/jats:sub>\n                      and insulin requirement were associated with mean TIR &gt;70%. At multivariable analysis, lower HbA\n                      <jats:sub>1c<\/jats:sub>\n                      remained independently associated with a better glycemic control. However, mean TIR increased more in participants with a higher baseline HbA\n                      <jats:sub>1c<\/jats:sub>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      Switching to an AHCL leads to a rapid improvement in glycemic control lasting for up to 24 months along with a low risk for hypoglycemia, confirming the safety of the system. Lower baseline HbA\n                      <jats:sub>1c<\/jats:sub>\n                      was the main predictor of better efficacy of therapy, although higher baseline HbA\n                      <jats:sub>1c<\/jats:sub>\n                      was associated with the greatest improvement in mean TIR.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/dia.2023.0261","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T11:35:57Z","timestamp":1698665757000},"page":"49-58","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["Advanced Hybrid Closed-Loop System Achieves and Maintains Recommended Time in Range Levels for Up To 2 Years: Predictors of Best Efficacy"],"prefix":"10.1177","volume":"26","author":[{"given":"Giuseppe","family":"Lepore","sequence":"first","affiliation":[{"name":"Unit of Endocrine Diseases and Diabetology, Department of Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00f2 Diego","family":"Borella","sequence":"additional","affiliation":[{"name":"Unit of Endocrine Diseases and Diabetology, Department of Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giona","family":"Castagna","sequence":"additional","affiliation":[{"name":"Unit of Endocrine Diseases and Diabetology, Department of Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy."},{"name":"Department of Medicine, Universit\u00e0 degli Studi di Milano-Bicocca, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Ippolito","sequence":"additional","affiliation":[{"name":"Unit of Endocrine Diseases and Diabetology, Department of Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Bonfadini","sequence":"additional","affiliation":[{"name":"Unit of Endocrine Diseases and Diabetology, Department of Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Corsi","sequence":"additional","affiliation":[{"name":"Unit of Endocrine Diseases and Diabetology, Department of Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiana","family":"Scaranna","sequence":"additional","affiliation":[{"name":"Unit of Endocrine Diseases and Diabetology, Department of Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro Roberto","family":"Dodesini","sequence":"additional","affiliation":[{"name":"Unit of Endocrine Diseases and Diabetology, Department of Medicine, ASST Papa Giovanni 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