P-135: The technological revolution in paediatric diabetes: trends in technology adoption and glycaemic control — a sweet registry analysis (2016–2025)
C Bastião de Almeida, J Vinhais, A Alonso, C Grácio, M Oliveira, A Simões, T Teixeira, C Matos, R Pereira, F Caetano, C Diamantino, A L Fitas, J Galhardo, L Lopes, C LimbertAbstract
Introduction
Achieving recommended glycaemic targets in paediatric type 1 diabetes (T1D) remains difficult despite major advances in care. Over the past decade, continuous glucose monitoring (CGM) and insulin pump therapy have become central to diabetes management, but real-world long-term data benchmarking local practice against international standards remain limited.
Objectives
To assess 10-year trends in diabetes technology use and glycaemic outcomes in a tertiary paediatric diabetes centre and compare them with the international SWEET registry.
Methods
We performed a retrospective observational study using SWEET registry data. Children and adolescents aged 0–18 years with T1D followed at a single tertiary centre between January 2016 and December 2025 were included and compared with the overall SWEET cohort. Annual CGM use, insulin pump use, HbA1c, time in range (TIR 70–180 mg/dL), time below range, and time above range were analysed.
Results
The local centre contributed 273–374 patients per year, compared with 29,499–56,875 annually in SWEET. CGM use increased from 3.4% in 2016 to 98.3% in 2024 locally, versus 27.0% to 79.7% in SWEET. Pump use rose from 9.1% in 2016 to 76.2% in 2025 locally, compared with 40.3% to 57.6% globally. Over the same period, mean HbA1c improved from 8.2% to 7.1% locally, versus 7.9% to 7.4% in SWEET. Between 2020 and 2025, TIR increased from 50% to 62% locally, compared with 52% to 58% globally, while time above range fell from 44% to 33%.
Conclusions
Over one decade, this centre achieved near-universal CGM uptake and substantial pump expansion, surpassing international SWEET trends. These changes were accompanied by meaningful improvements in HbA1c and sensor-derived glycaemic metrics. Our findings provide real-world evidence that broad technology implementation, embedded within specialised multidisciplinary care, can translate into better outcomes in paediatric T1D, although further progress is still needed to help more young people achieve the recommended targets.