Diabetes Dialogue: Omnipod 5 and Medtronic 780G for Type 2 Diabetes

Welcome back to Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives!

In this episode of Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, discuss a pair of recently published studies examining the use of diabetes technology in adults with type 2 diabetes.

SECURE-T2D

A single-arm prospective study conducted at 21 US clinical centers, SECURE-T2D assessed the impact of automated insulin delivery (AID) on glycemic control in adults with type 2 diabetes using insulin for at least 3 months. The study enrolled 305 participants (mean age, 57 years; 57% female), with a diverse racial and ethnic representation, including 24% Black and 22% Hispanic or Latino.

Following a 14-day standard therapy phase, participants used the Omnipod 5 AID system for 13 weeks. HbA1c decreased from 8.2% (SD, 1.3) at baseline to 7.4% (SD, 0.9) (mean difference, -0.8 percentage points; 95% CI, -1.0 to -0.7; P <.001) and time in range (70-180 mg/dL) increased from 45% (SD, 25) to 66% (SD, 17) (mean difference, 20 percentage points; 95% CI, 18 to 22; P <.001).

Improvement was observed across subgroups, regardless of concurrent GLP-1 RA or SGLT2 inhibitor use or pretrial insulin regimen. Rates of hypoglycemia remained noninferior to standard therapy, with one severe hypoglycemia event and no cases of diabetic ketoacidosis or hyperosmolar hyperglycemic syndrome. Findings suggest AID may be a safe and effective option for insulin-requiring adults with type 2 diabetes.

Medtronic 780G in Type 2 Diabetes

A 13-site, single-arm, open-label study evaluated the safety and effectiveness of the MiniMed™ 780G advanced hybrid closed-loop (AHCL) system in 95 adults with insulin-requiring type 2 diabetes. Over the 90-day study period, mean HbA1c decreased from 7.9% (SD, 1.0%) to 7.2% (SD, 0.7%) (P < 0.001), and the percentage of time in range of 70 to 180 mg/dL) reached 80.9% (95% CI, 78.4% to 83.1%).

Total daily insulin dose increased from 77.4 U (SD, 38.5) to 91.8 U (SD, 49.3) (P<.0001), while carbohydrate intake remained stable, and user-initiated boluses decreased. Investigators pointed out no significant changes in participant weight or body mass index were observed during the study and there were no reports of severe hypoglycemia, diabetic ketoacidosis, hyperosmolar hyperglycemic state, or serious adverse events.

Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.

References:

1. Pasquel FJ, Davis GM, Huffman DM, et al. Automated Insulin Delivery in Adults With Type 2 Diabetes: A Nonrandomized Clinical Trial. JAMA Netw Open. 2025;8(2):e2459348. doi:10.1001/jamanetworkopen.2024.59348

2. Bhargava A, Bergenstal RM, Warren ML, et al. Safety and Effectiveness of MiniMed™ 780G Advanced Hybrid Closed-Loop Insulin Intensification in Adults with Insulin-Requiring Type 2 Diabetes. Diabetes Technol Ther. Published online February 6, 2025. doi:10.1089/dia.2024.0586