MON-LB052 Efficacy and Safety of Minimed 670G Automode in Children with Type 1 Diabetes Less Than 8 Years Old

Introduction: The Medtronic MiniMed 670G system with SmartGuardTM (Medtronic, Northridge, CA) is a commercial hybrid closed-loop (HCL) system approved for use in 2017 for children >8 years of age. Studies of the system in children >7 years old, adolescents, and adults show improvement in glycemic control when using the HCL system or automode (AM) [1]. There has been no study describing the use of the system in young children. Children <8 can have extensive glucose variability related to eating patterns, activity, and growth. Glycemic excursions may be better controlled with a HCL system. We reviewed patients at our institution with type 1 diabetes (T1D) <7 years of age who were on the 670G HCL system for at least 3 months to see if glycemic control improved. Case Series: We reviewed children <8 years of age with T1D at our institution who had been on the 670G for at least 3 months. We compared 2 week data obtained from Carelink while in an open loop system or manual mode (MM) to those in AM. We excluded those who did not have available hemoglobin A1C +/- 30 days from the download. We used 2 tailed t-test to compare A1C, percentage time in range (TIR), percentage of hypoglycemia, average sensor glucose, average sensor glucose standard deviation (SD). Results: 16 children were reviewed (age of AM start: range 2-6, average 4.3 years; 10 male). The time in AM was average 6.3 +/- 2.9 months (range 3-12). Average percent time in AM was 79 +/- 13.6 (range 57-98). There was a statistically significant change for A1C (MM 7.9%, AM 7.4%; p-value <0.001), percentage TIR (MM 42.8%, AM 56.2%; p-value <0.001), percentage hypoglycemia (MM 1.3%, AM 2.4%; p-value 0.04), average sensor glucose (MM 200, AM 176; p-value <0.001). There was no significant difference in average sensor SD. No adverse events were noted during the time of review. Conclusion: This case series showed an improvement in glycemic control noted by A1C, percentage TIR, average sensor glucose. We did note significantly more hypoglycemia although no serious adverse events were reported. A HCL system can be used in young children with T1DM safely and effectively and should be an option for children < 7 years. 1. Forlenza, G.P., et al., Safety Evaluation of the MiniMed 670G System in Children 7-13 Years of Age with Type 1 Diabetes. Diabetes Technol Ther, 2019. 21(1): p. 11-19. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.