Background: Advanced hybrid closed-loop (AHCL) systems have improved the glycemic control in type 1 diabetes (T1D). While time in range (TIR) (70–180 mg/dL) is the standard metric, time in tight range (TITR) (70–140 mg/dL) offers a stricter assessment. Real-world comparisons using the TITR are limited. This study compared the TIR and TITR metrics between the MiniMed™ 780G and Tandem Control-IQ™ in adults with T1D. Methods: This retrospective, single-center study included 42 propensity-score-matched adults with T1D (28 MM780G users and 14 Tandem Control-IQ users), each with ≥3 months of AHCL system use. Glycemic metrics from continuous glucose monitoring (CGM) were analyzed over a 14-day period. Comparisons between groups were conducted using Mann–Whitney U tests, adjusted linear regression, and linear mixed-effects models accounting for repeated measures. Results: At three months, the MM780G users achieved significantly higher TITR (60.1% ± 12 vs. 49.5% ± 9.3; p = 0.005) and TIR (83.7% ± 7.6 vs. 72.1% ± 7.5; p < 0.001) values, along with lower glucose variability, compared to these values in the Tandem Control-IQ users. The linear regression model confirmed that the MM780G was independently associated with a higher TITR (β = 14.2; p = 0.005). Mixed-effects modeling for the TIR showed a significant interaction between timepoint and device type (β = 4.81; p = 0.006), favoring the MM780G. Conclusions: In this real-world analysis, both AHCL systems improved glycemic control, but the MiniMed 780G could be associated with a superior performance in achieving tighter glucose targets without increasing hypoglycemia. TITR may serve as a valuable complementary metric alongside TIR in evaluating AHCL systems’ effectiveness. However, these findings should be interpreted cautiously due to limitations such as the retrospective design, small sample size, potential residual confounding, and lack of standardization in the device settings. Further studies are warranted to confirm these results and assess their generalizability.

Background: Growth hormone and insulin-like growth factor 1 (IGF-1) have recently been linked to temporal muscle thickness (TMT) in acromegaly; however, the relationship between treatment response and TMT remains unclear. Objectives: To evaluate whether TMT correlates with treatment response and may serve as a surrogate marker of disease control in patients with acromegaly. Design: Retrospective longitudinal two-center study. Methods: Patients with acromegaly and non-functioning pituitary adenomas (NFPA) were included. TMT was measured on magnetic resonance imaging scans obtained before treatment initiation and after a 3-year follow-up. Baseline TMT was compared between groups. In patients with acromegaly, TMT was correlated with IGF-1 levels at diagnosis and over time, as well as with treatment response. Mixed-effects regression models adjusted for covariates were used to assess associations. Results: Imaging studies from 58 subjects were analyzed (40 with acromegaly, 18 with NFPA). Pre-treatment TMT was significantly greater in patients with acromegaly compared with NFPA (mean 10.1 mm (9.3–10.7) vs 8.1 mm (8.0–9.2), p = 0.003). Higher baseline TMT was associated with higher IGF-1 levels at diagnosis ( p < 0.01). Following treatment, mean TMT decreased from 9.6 mm at baseline to 8.8 mm at 36 months ( p = 0.001). In covariate-adjusted mixed-effects models, higher pre-treatment TMT was independently associated with increased IGF-1 levels at diagnosis and longitudinally (β = 19.59 ng/mL, p = 0.022). Conclusion: TMT correlates with biochemical disease activity and decreases after treatment, suggesting it may be a useful imaging marker of clinical activity and prognosis in acromegaly. Trial registration: Not applicable.

Severe hyperandrogenism with new-onset virilization in postmenopausal women is rare and often associated with androgen-secreting tumors. Nevertheless, a comprehensive differential diagnosis must be considered, including ovarian hyperthecosis and Cushing syndrome. We report a 71-year-old woman with progressive hirsutism over 1-2 years, presenting with severe hyperandrogenism and insulin resistance. Physical examination revealed moderate hirsutism with a score of 15 according to the modified Ferriman–Gallwey scale, androgenic alopecia, dental diastema, macroglossia, and acanthosis. Hormonal analysis demonstrated elevated free testosterone levels on two separate occasions: 8.1 ng/mL (SI: 28 nmol/L) and 6.7 ng/mL (SI: 23.2 nmol/L) (reference range 0.12-0.35 ng/mL [SI 0.42-1.22 nmol/L]); with all other androgenic parameters within the normal range. Imaging studies, including abdominal computed tomography (CT) and transvaginal ultrasound, showed normal adrenal glands and adnexa. Based on clinical suspicion, the patient underwent bilateral adnexectomy. Histopathology confirmed a bilateral ovarian steroid cell tumor, not otherwise specified. Postoperatively, serum testosterone normalized (0.16 ng/mL [SI: 0.55 nmol/L]) within one month with progressive improvement in hirsutism.