Real-world glycaemic outcomes of a tubeless automated insulin delivery system (Medtrum A8 TouchCare) in adults with type 1 diabetes

BACKGROUND: Automated insulin delivery (AID) systems are recommended as first-line therapy for type 1 diabetes. The Medtrum A8 TouchCare is a tubeless AID system powered by the APGO algorithm, which modulates basal insulin and delivers automatic correction micro-boluses. Real-world evidence on this system remains extremely limited. AIM: To evaluate the efficacy of the Medtrum A8 TouchCare in AID mode in a real-world cohort of adults with type 1 diabetes. METHODS: We conducted a single-center, observational, retrospective study at Federico II University Hospital, Naples, Italy (January-October 2025). Adults with type 1 diabetes of at least six months' duration using the Medtrum A8 TouchCare in AID mode were included. Continuous glucose monitoring metrics and clinical parameters were compared at baseline and after three months. The primary endpoint was the change in time in range (TIR). RESULTS: Twenty patients were included (mean age 39 ± 6 years; diabetes duration 18 ± 6 years). After three months, TIR increased by 12.51% (p < 0.05), TAR1 and TAR2 decreased by 7.2% (p < 0.05) and 5.97% (p < 0.05), respectively. GMI improved by 0.46% (p < 0.05), GRI by 13.75 points (p < 0.05), and HbA1c decreased by 0.52% (p < 0.05). No significant changes were observed in TBR1, TBR2, or CV, and no severe hypoglycaemia episodes occurred. CONCLUSIONS: The Medtrum A8 TouchCare in AID mode significantly improved glycaemic control without increasing hypoglycaemia. These findings support the efficacy of this tubeless AID system and warrant confirmation in larger prospective studies.