P-134: Timing of insulin pump initiation in recently diagnosed young children with T1D
R Longendyke, J Grundman, L Holly, M Tran, A Perkins, R Streisand, S MajidiAbstract
Introduction
Young children with T1D and their families face challenges related to diabetes management, some of which can be alleviated with use of diabetes technology, underscoring the importance of timely access in this population.
Objectives
We investigated the impact of timing of insulin pump initiation on diabetes outcomes in young children.
Methods
We included youth <7y at diagnosis between 7/1/2024 and 7/1/2025. We collected demographic information and divided youth into three groups based on timing of insulin pump initiation from diagnosis: “fast” (<120 days), “slow” (>120 days), and “no pump.” One-way ANOVA assessed differences in diabetes outcomes.
Results
Thirty-seven youth were identified (average age at diagnosis 4.2y, 59% male, 5% Asian, 24% Black, 43% Caucasian, 27% other race, 46% publicly insured, mean A1c 7.4% ±1.1). Ten (27%) patients started on pumps <120 days post-diagnosis, 15 (41%) patients started >120 days post-diagnosis, and 12 (32%) were not on pumps. Those who started on pumps <120 days after diagnosis had a lower average A1c (6.8%) compared to those who were slow to start (7.6%), and those not on pumps (7.8%) (p=0.01). TIR was significantly higher in the fast group (62%) compared to the slow group (49%) and those not on pumps (39%) (p=0.01). TAR was significantly lower in the fast group (37%) compared to the slow group (48%) and those not on pumps (60%) (p= 0.02). TBR was similar across groups: fast group 1%, slow group 2%, and no pump group 1% (p= 0.14).
Conclusions
In this cohort of recently diagnosed young children with T1D, those who started on insulin pumps less than 120 days after diagnosis had lower A1c, higher TIR, and lower TAR compared to those who started more than 120 days post-diagnosis and those not using pumps. Findings suggest that clinicians should prioritize prompt access to diabetes technology in this population. Future directions include investigating whether these improvements in glycemic outcomes are sustained over time.