O-24: Glycemic outcomes and automated insulin delivery in over 140 000 children with type 1 diabetes: a 5-year longitudinal follow-up from paediatric diabetes registries
V Neuman, Z Sumnik, O Cinek, B Karges, B Rami-Merhar, S J Kummernes, N A Lund-Blix, T Skrivarhaug, J T Warner, A Krayem, S Pons Perez, D M Maahs, J C Wong, S Rompicherla, G T Alonso, H Bratke, M Witsch, S LanzingerAbstract
Introduction
Throughout recent years, diabetes control have improved significantly in children and adolescents with type 1 diabetes (CwD), partly due to technological advances.
Objectives
The aim of this study was to perform a longitudinal analysis of HbA1c in CwD using automated insulin delivery (AID) between 2020 and 2024 utilising data from five national and one international paediatric diabetes registries.
Methods
Data was taken from the Czech National Diabetes Registry, Diabetes Prospective Follow-up Registry, Norwegian Childhood Diabetes Registry, National Paediatric Diabetes Audit for England and Wales, T1D Exchange Quality Improvement Collaborative USA and the SWEET initiative. All children (≤ 18 years) with type 1 diabetes were included. Data on demographics, HbA1c and AID use were collected for the years 2020-2024. The proportion of AID use over time was analyzed using a Gamma model, changes in other outcomes were examined using linear regression models.
Results
In 2024, data were available for 104 332 CwD from the national registries and 41 815 from SWEET. The aggregate mean HbA1c decreased from 8.0 (95% CI: 7.9-8.0) to 7.6 (7.5-7.7%) (P<0.001) and the proportion of CwD achieving the HbA1c target <6.5% increased from 13.6% (12.2-15.0) to 19.2% (17.7-20.6) (Fig. 1A) and those with HbA1c >9.0% decreased from 18.4% (17.7-19.1) to 12.8% (12.1-13.5) (Fig.1B) (both P<0.001). The proportion of AID users increased from 4.7% (3.8-5.8) to 48.4% (41.8-56.1) (P<0.001). The aggregate mean HbA1c in AID users decreased from 7.6 (7.5-7.8) to 7.4 (7.3-7.5%) with the proportion of those reaching the <6.5% target increasing from 11.7% (8.4-15.0) to 19.3% (17.1-21.5) (Fig. 1C) and those >9.0% decreasing from 9.9% (7.3-12.6) to 7.3% (5.6-9.1) (Fig. 1D) (all P<0.001).
Conclusions
HbA1c improved significantly between the years 2020 - 2024, with an increasing proportion of children reaching optimal HbA1c values. These results coincide with the increase in the use of AID.