**1. Introduction**

According to American Diabetes Association (ADA), immune-mediated diabetes, also known as "insulin-dependent diabetes," caused by cellular-mediated autoimmune destruction of the pancreatic β-cells, accounts for 5–10% of diabetes, making it the major of the two subcategories of type 1 diabetes. Islet cell autoantibodies and autoantibodies to GAD (glutamic acid decarboxylase, GAD65), insulin, the tyrosine phosphatases islet antigen 2 (IA-2) and Ia-2β, and zinc transporter 8, represent autoimmune markers. Only a minority of people with diabetes fall into the second subcategory, idiopathic T1D, with no evident β-cell autoimmunity, higher susceptibility to ketoacidosis, and permanent insulinopenia [1, 2]. The ADA's clinical practice recommendations in "Standards of Medical Care in Diabetes—2022" state that the ideal HbA1c concentration should be lower than 53 mmol/mol (7%) as it correlates to a 50–76% decrease in microvascular complications (retinopathy, neuropathy, and diabetic kidney disease), development, and progression [3]. However, for many people

with T1D, despite the availability of the latest innovative technology in insulin therapy, achieving the recommended target remains challenging [4–6].

When considering methods of treatment, insulin pumps should be made accessible to all people with insulin-deficient diabetes, nonetheless, specific circumstances, desires, and needs of the patient should be brought into account [6, 7]. Offering the latest available technology to all patients is one of many priorities in our hospital, including sensor-augmented pumps from Medtronic MiniMed in T1D.

The latest MiniMed 780G (**Figure 1**) system, the successor to MiniMed 640G and 670G, is equipped with advanced hybrid closed-loop (AHCL) [8–10]. The AHCL system is composed of CGM and an insulin pump. The continual administration of selfadjusting basal insulin delivery and correctional boluses every 5 minutes is based on glycemia measured in real-time. This may prevent hypoglycemia, while also making it safe, effective, and more comfortable to use [5, 8–11]. Even CGM alone has proven to be more effective than manual self-monitoring with a glucometer [12–14]. Insulin delivery *via* this system represents a near-physiological mechanism; it mimics endogenous insulin secretion to the extent of minimal need for manual user intervention [15–18]. For optimal results, in the traditional "Manual mode," the number of saccharides should be entered and the bolus calculator ("bolus Wizard") may be used as an advisor. In the "Smart Guard" mode the user needs to enter only the number of saccharides [9, 18]. The CareLink system creates person-related graphs (**Figure 2**) depicting CGM, saccharide intake, and insulin infusions, providing an organized overview for the user and their healthcare provider. Time in range (TIR) is the amount of time spent in target glycemia, represented as a percentage, in the course of defined period.

Based on previous data, the algorithm may predict glycemia and the body's reaction to insulin delivery. Therefore, it can be expected that with a longer period of use comes better control of glycaemic targets. Some other factors that play a role in optimal results include; correct application and fixation of the cannula and infusion set; turning off insulin delivery when taking off the pump (for example during showers, sports, and sex). At night, the algorithm controls glycemia according to the automatic basal rate, regardless of evening glycemia. This enables users to stay in range without any active intervention for the duration of their sleep [18]. Anyone

### **Figure 1.**

*Insulin pump MiniMed 780G: the SmartGuard mode showing glycaemia 7.4 mmol/l (on the left), and time in range (TIR) 89% (on the right).*

*Benefits of Implementation of Insulin Pump in People with Type 1 Diabetes: 10 Case Reports DOI: http://dx.doi.org/10.5772/intechopen.110073*


## **Figure 2.**

*This CareLink graph depicts two shaded areas of data: blue and orange, each area representing information about glycemia from a date range (A and B), (see left corner). The black dotted line in the middle represents average glycemia from the last date range (A). The darker shaded blue area represents 25–75% of all sensor readings, meaning this is where the majority of glucose readings have been. The remainder of the data is in the 0–90% range presented within the solid blue line. Data from the date range (B) are colored orange behind the blue plot. This report should be reviewed with one's healthcare professional to see progress from the last visit or the last device settings change [19]. The internet address specified for each user is www.carelink.minimed.eu.*

using the technology should be well informed on how AHCL algorithms work, and most importantly how to use it to get the maximum benefit out of it [20].
