All-in-one sensor design with overlapping sensor transition reduces automode interruptions and improves patient-reported outcomes in adolescents with type 1 diabetes: real-world evidence from simplera sync integration

Aims: To assess the real-world impact of transitioning from Guardian 4 to Simplera Sync sensor on automated insulin delivery and patient-reported outcomes in adolescents using the Minimed 780G system. Methods: Multicentre retrospective observational study of 42 adolescents with type 1 diabetes (median age 12.0 years) established on SmartGuard ≥ 6 months. Fourteen centres each enrolled three consecutive eligible patients. Both observation windows fell within the school term, with no pump settings changed. Continuous glucose monitoring metrics and Diabetes Intrusiveness, Difficulty and Self-care Scale scores were compared between the final two weeks of Guardian 4 use and the final two weeks after transitioning to Simplera Sync. Results: Time in automated mode increased from 95.3% to 97.1% (+1.8 percentage points, approximately 23 min/day; p < 0.02). Time in range (70-180 mg/dL) increased from 76.7% to 79.3% (p < 0.05), mean glucose fell from 146.0 to 141.3 mg/dL (p < 0.05), and time above 250 mg/dL decreased from 3.0% to 2.0% (p < 0.01), with no worsening of hypoglycaemia. Treatment satisfaction increased and perceived burden decreased (both p < 0.01). Conclusions: Overlapping sensor transition was associated with increased automated delivery, modest glycaemic improvement and reduced device burden. The fully disposable design may eliminate transmitter-recharging interruptions; prospective validation is required.