Sustained Glycemic Outcomes with the MiniMed™ 780G System: Real-World Evidence from >16,000 Users Across 18 Latin American Countries Over Two Years.

BACKGROUND AND AIMS: Automated insulin delivery (AID) systems achieve consistent glycemic outcomes in real-world settings, yet access across Latin America (LATAM) remains critically low, with marked disparities driven by demographic, structural, and health care infrastructure heterogeneity across the region. This study characterizes the real-world performance of the MiniMed™ 780G (MM780G) advanced hybrid closed-loop (AHCL) system across 18 LATAM countries and evaluates the durability of glycemic outcomes over 24 months. METHODS: Data from 16,669 individuals with type 1 diabetes using the MM780G system across 18 LATAM countries (January 2020-October 2025) were analyzed; 27.1% were pediatric (<16 years) and 70.8% adult (≥16 years). Primary outcomes included time in range (TIR), time in tight range (TITR), glucose management indicator (GMI), and time below range (TBR), stratified by age, sex, country, and recommended optimal settings (ROS: glucose target 100 mg/dL, active insulin time 2 h, ≥95% of time). A longitudinal sub-analysis followed 1204 users across 24 consecutive monthly time points. RESULTS: Overall, mean TIR was 73.4% and GMI 6.9%, with TBR within consensus targets; approximately two-thirds of users achieved TIR > 70% and GMI < 7.0%. ROS was adopted by 19.2% of users, which was associated with substantially improved outcomes, with mean TIR 77.5%, TIR > 70% attainment occurred in 83.9% of users, and composite target of GMI < 7, TIR > 70, TB70 < 4 and TB54 < 1 attainment rising to 66.4%. Pediatric users met or exceeded (with ROS) the internationally recommended 70%TIR threshold (mean overall TIR 70.0% and 74.2% with ROS), while adults (mean TIR 74.6%) aligned closely with US and Europe, Middle East and Africa real-world benchmarks. TITR exceeded 50% in adults (50.3% overall and 54.1% with ROS) and exceeded the International Society for Pediatric and Adolescent Diabetes (ISPAD) 2024 recommended threshold of 50% in pediatric users (mean TITR 51.2% with ROS). Outcomes were consistent across sex and all five national cohorts. In the 24-month longitudinal sub-analysis, TIR remained clinically stable within one and a half percentage points throughout both age groups. CONCLUSION: The MiniMed™ 780G AHCL system delivered consistent and durable glycemic control over 24 months across the full demographic and structural heterogeneity of Latin America. Performance was aligned with internationally recommended consensus targets and was independent of age, sex, country, and health care infrastructure. Eliminating barriers to AID access is an immediate and achievable priority in the region and may improve the health of hundreds of thousands of people with diabetes in Latin America.