1866-P: MiniMed 780G Advanced Hybrid Closed-Loop (AHCL) Glycemic Benefits Are Observed across a Range of C-Peptide Levels in People with Type 2 Diabetes (PWT2D)

Introduction and Objective: The ADA Standards of Care state that automated insulin delivery (AID) systems are the preferred insulin delivery method for basal/bolus insulin-requiring T2D and that there should be no C-peptide level requirement for AID therapy initiation.1 As MiniMed™ 780G system with Simplera Sync™ sensor (MM780G+SimSync) use demonstrated significantly improved A1C and time in range (%TIR) in PwT2D,2 this study explored glycemic outcomes across baseline C-peptide levels. Methods: The IMPACT2D trial (31 sites) evaluated MM780G+SimSync use in GAD65 autoantibody-negative PwT2D (N=236, aged 59.7±11.2yrs, 19.2±9.7yrs T2D duration). Random local lab C-peptide level was measured at baseline and participants underwent a run-in period (~21d) of open-loop or HCL use before entering the AHCL study period (~90d). Glycemic metrics and insulin delivery during the last 6 weeks of the study period were compared to those from the run-in, and stratified across C-peptide level. Results: Compared to run-in, mean %TIR and %TITR were increased, while mean A1C, sensor glucose, glucose management indicator and %TBR were reduced for the above-, within-, and below-range C-peptide groups (Table). Conclusion: PwT2D requiring basal/bolus insulin achieve glycemic control benefits with the MM780G system irrespective of random C-peptide level, further supporting the ADA recommendations of AID therapy. Disclosure A. Carlson: Research Support; Current; Abbott Diabetes, Dexcom, Inc., Eli Lilly and Company. Other - Research support and consulting/speaking; Current; Insulet Corporation. Research Support; Current; Lexicon Pharmaceuticals, Inc. Advisory Panel; Current; MannKind Corporation. Other - Research support and advisory panel; Current; Medtronic, Novo Nordisk A/S, Zealand Pharma A/S. Advisory Panel; Current; Tandem Diabetes Care, Inc. J.R. Thrasher: Advisory Panel; Current; Medtronic. Consultant; Current; Medtronic. Research Support; Current; Medtronic. Advisory Panel; Current; Novo Nordisk. Research Support; Current; Novo Nordisk. Advisory Panel; Current; Eli Lilly and Company. Research Support; Current; Eli Lilly and Company. Advisory Panel; Current; Novo Nordisk. Research Support; Current; Novo Nordisk, AstraZeneca, Zealand Pharma A/S, Merck Current; Eli Lilly and Company, Novo Nordisk. S. Lee: Other - dsmb for twist study; Current; Jaeb Center for Health Research. K. Codorniz: Research Support; Current; Medtronic, MannKind Corporation. D. Shulman: Advisory Panel; Current; Medtronic. Advisory Panel; Ended; Novo Nordisk. Other - Data monitoring committee; Current; BridgeBio Pharma, Inc. M.L. Warren: Speaker's Bureau; Current; Abbott Diabetes. Research Support; Ended; Medtronic. Research Support; Current; Amgen Inc. Speaker's Bureau; Current; Amgen Inc. Research Support; Current; Boehringer Ingelheim International GmbH, Eli Lilly and Company. Speaker's Bureau; Current; Lilly, MannKind Corporation. Research Support; Current; Novo Nordisk, Corcept Therapeutics. Research Support; Ended; Diasome. Research Support; Current; BridgeBio Pharma, Inc. C. Jacobson: Advisory Panel; Current; Medtronic. R.M. Bergenstal: Other - Advisory Panel, Consultant, Clinical Research Support; Current; Abbott Diabetes. Other - Consultant, Clinical Research Support; Current; Dexcom, Inc. Research Support; Current; Amgen Inc. Advisory Panel; Current; CeQur SA. Other - Advisory Panel, Consultant, Clinical Research Support; Current; Eli Lilly and Company. Research Support; Current; Insulet Corporation. Research Support; Ended; Luna. Research Support; Current; Medtronic. Other - Advisory Panel, Consultant, Clinical Research Support; Current; Novo Nordisk. Research Support; Current; Tandem Diabetes Care, Inc. Consultant; Current; Sanofi. Advisory Panel; Current; Vertex Pharmaceuticals Incorporated. Research Support; Current; Zealand Pharma A/S, Sequel, Embecta. F.E. Broyles: None. L.K. Billings: Advisory Panel; Current; Novo Nordisk, Lilly, Sanofi, Amgen Inc., Bayer AG. D. Ahn: Speaker's Bureau; Current; Abbott, Ascensia Diabetes Care, MannKind Corporation, Insulet Corporation, Lilly, Novo Nordisk, Xeris Pharmaceuticals, Inc., Sequel Medtech, Dexcom, Inc. Advisory Panel; Ended; Lilly, MannKind Corporation. S. Wakeley: None. L. Poretsky: None. D. Lender: None. T. Bailey: Advisory Panel; Current; Abbott Diabetes. Research Support; Current; Abbott Diabetes, Biolinq, Dexcom, Inc., Senseonics, Medtronic. Consultant; Current; i-SENS, Inc., Sanofi, Roche Diabetes Care. Research Support; Current; Roche Diabetes Care, Eli Lilly and Company, vTv Therapeutics. A. Manessis: None. A. Kansara: Research Support; Current; Eli Lilly and Company. Research Support; Ended; Medtronic. Research Support; Current; Arrowhead Pharmaceuticals, Calcilytix, Inc. Research Support; Ended; Amolyt. Research Support; Current; Endogenex. Advisory Panel; Ended; Veracyte, Crinetics Pharmaceuticals, Inc. J.Y. Park: None. P.F. Mora: Speaker's Bureau; Current; Abbott Diabetes. Advisory Panel; Current; Novo Nordisk. Speaker's Bureau; Current; Novo Nordisk, Dexcom, Inc. Consultant; Current; Medtronic. Speaker's Bureau; Current; Insulet Corporation. J.H. Reed: None. A. Bhargava: Other - Research grant; Current; Amgen Inc. Consultant; Current; Verdiva Bio. Other - Research grant; Current; Endogenix, Gasherbrum, vTv Therapeutics, Boehringer Ingelheim Pharmaceuticals, Inc, Abbott Diabetes, Covance, Dexcom, Inc., Eli Lilly and Company, Madrigal Pharmaceuticals, Inc. Consultant; Current; Boehringer Ingelheim Pharmaceuticals, Inc. Other - Research grant; Current; Medtronic Inc, Novo Nordisk. Consultant; Current; Novo Nordisk. Other - Research grant; Current; MannKind Corporation, Carmot Therapeutics Inc, Quintiles, Akero Therapeutics Inc, 89bio, Inc., Viking Therapeutics, Barbara Davis Center for Diabetes, PPD Inc, Zydus Therapeutics. Other - Research grant; Ended; Kowa Company, Ltd., Insulet Corporation. Other - Research grant; Current; AstraZeneca, DEKA Research Corporation, Zealand Pharma A/S. D. Klonoff: Advisory Panel; Current; Afon Technology, Atropos Health, Embecta, Glooko, Inc., Glucotrack, Lifecare, Inc. Advisory Panel; Ended; Novo Nordisk. Advisory Panel; Current; Sanofi, Synchneuro, Thirdwayv Inc. M. Dworak: Employee; Current; Medtronic. A. Keiter: None. J.J. Shin: Employee; Current; Medtronic. J. McVean: Employee; Current; Medtronic. T. Cordero: Employee; Current; Medtronic. R. Vigersky: Employee; Current; Medtronic.