{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:49:22Z","timestamp":1786121362983,"version":"build-2736575974"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007657","name":"Univerza v Ljubljani","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007657","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Diabetes self-management in older adults with type 1 diabetes (T1D) presents a unique clinical challenge, since maintaining tight glycemic control must be carefully weighed against age-related vulnerabilities. This study aimed to analyze glycemic control through the effects of customized algorithm settings in a cohort of older adults with T1D using an automated insulin delivery (AID) system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective real-world data analysis included users of the MiniMed\u2122 780G AID system, aged \u226560 years. Continuous glucose monitoring (CGM) data including time in range (TIR; 70\u2013180 mg\/dL; 3.9\u201310.0 mmol\/L), time in tight range (TITR; 70\u2013140 mg\/dL; 3.9\u20137.8 mmol\/L), time below range (TBR; &amp;lt;70 mg\/dL; &amp;lt;3.9 mmol\/L), level 2 TBR (&amp;lt;54 mg\/dL; &amp;lt;3.0 mmol\/L) and time above range (TAR; &amp;gt;180 mg\/dL; &amp;gt;10.0 mmol\/L) were analyzed alongside algorithm settings and daily insulin use. Group comparisons utilized standard parametric and non-parametric statistical tests. A multivariable logistic regression model identified independent clinical predictors of high glycemic performance (TITR \u226550%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort comprised 97 AID users (70.1% female, mean age 67.9 \u00b1 6.7; range 60\u201390 years). Overall glycemic control was good, with mean TIR 76.1%, TITR 51.1% and TBR 1.1%. Fourteen participants (14.4%) used the manufacturer\u2019s recommended optimal settings (ROS); i.e., target glucose of 5.5 mmol\/L and active insulin time of 2 hours. CGM metrics did not differ between ROS and non-ROS users for TIR, TITR and TBR. When stratifying the cohort by glycemic performance, 55 participants (56.7%) reached TITR \u226550%; however, the adoption of ROS in high (\u226550%) TITR and lower (&amp;lt;50%) TITR subgroups was similar (16.4% vs 11.9%; Fisher p=0.58). When compared to the lower TITR subgroup, participants in the high TITR subgroup delivered less auto-correction insulin (14.2% vs 20.6%, p&amp;lt;0.001) and a higher proportion of manual bolus insulin (46.1% vs 35.2%, p&amp;lt;0.001), which remained a significant predictor of high TITR after multivariable adjustment. TBR was significantly higher in the high (\u226550%) TITR subgroup, although it remained low in absolute terms (1.5% vs. 0.8%; p=0.017).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While the MiniMed\u2122 780G AID system use is associated with low CGM-derived hypoglycemia exposure and highly effective glycemic control, regardless of customized settings, superior glycemic control is associated with a higher proportion of user-initiated manual boluses. The algorithm supports, but cannot replace, user engagement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1910192","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T04:22:22Z","timestamp":1786076542000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Insulin delivery characteristics and glycemic control in older adults with type 1 diabetes using the Minimed\u2122 780G system: a real-world analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"\u0160pela","family":"Vol\u010dan\u0161ek","sequence":"first","affiliation":[{"name":"University Medical Centre Ljubljana, Department of Endocrinology, Diabetes and Metabolic Diseases","place":["Ljubljana, Slovenia"]},{"name":"Faculty of Medicine, University of Ljubljana","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Vidmar","sequence":"additional","affiliation":[{"name":"University Medical Centre Ljubljana, Department of Endocrinology, Diabetes and Metabolic Diseases","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrej","family":"Jane\u017e","sequence":"additional","affiliation":[{"name":"University Medical Centre Ljubljana, Department of Endocrinology, Diabetes and Metabolic Diseases","place":["Ljubljana, Slovenia"]},{"name":"Faculty of Medicine, University of Ljubljana","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ale\u0161","family":"Skvar\u010da","sequence":"additional","affiliation":[{"name":"University Medical Centre Ljubljana, Department of Endocrinology, Diabetes and Metabolic Diseases","place":["Ljubljana, Slovenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.2337\/dc26-S013","article-title":"13. 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