Background: Automated hybrid closed loop systems (AHCLS) improve glucose control in people with type 1 diabetes (T1D). Whether AHCLS work as well also in people with latent autoimmune diabetes in adults (LADA) is not clear. Methods: In this study we collected continuous glucose monitoring reports from 17 people with LADA using the AHCLS Medtronic MiniMed™ 780G (Group A) matched 1:2:2:2 for age and body mass index (BMI) with people affected by LADA on MDI+CGM (group B) and with people affected by T1D using the same AHCLS (Group C) or using MDI+CGM (group D). Clinical and biochemical features were retrieved from electronic medical records. The effect of AHCLS compared to MDI+CGM on time in range (TIR), time above range (TAR), time below range (TBR), glucose management indicator (GMI), coefficient of variation (CV) were tested in regression models accounting for age, sex, BMI, and disease duration as confounders. The different effect of ACHLS in LADA and T1D was tested by fitting an interaction term between type of insulin therapy (AHCLS/MDI) and type of diabetes (LADA/T1D). Results: Population features are summarized in Table 1. Patients on AHCLS showed higher TIR than people on MDI (75 [64-83]% vs 60 [48-71]% p<0.001). Compared to MDI, AHCLS was also associated with lower TAR (21 [16-33]% vs 34 [25-50]% p<0.001), TBR (1[1-2]% vs 2[1-5]% p=0.011), GMI (6.8[6.6-7.2]% vs 7.2 [6.7-7.8]% p=0.0072), and CV (31[28-34]% vs 34[30-39]% p=0.0021). Among people on MDI+CGM, those with LADA showed higher TIR than those with T1D (66[54-77]% vs 55[41-60]% p=0.0057), lower TAR (31[21-44]% vs 41[32-58]% p=0.035), TBR (1[0-4]% vs 3[1-6]% p=0.027). Nonetheless the effect of AHCLS on TIR and TAR did not differ between people with T1D or LADA (p-value for interaction=0.23, and 0.58, respectively). Conclusions: This study for the first time explores the efficacy of an AHCLS in people with LADA, showing that it is associated with better glycemic control compared to MDI+CGM, similarly to what observed in people with early onset T1D.
