P-145: Four-year real-world glycemic outcomes of an automated insulin delivery initiated at type 1 diabetes onset in young children
D Tinti, C Nobili, G Prandi, N Abbruzzese, M Trada, A Rosso, L de SanctisAbstract
Introduction
MiniMed 780G is widely used in pediatric type 1 diabetes (T1D), but real-world data beyond 2 years for systems initiated at diagnosis are lacking.
Objectives
To describe the HbA1c trajectory over 4 years in children who started MiniMed 780G at T1D diagnosis.
Methods
Retrospective single-center study (Turin, Italy). Children initiating 780G at T1D diagnosis were followed with HbA1c assessments at 6, 12, 24, 36, and 48 months. Within-patient paired t-test assessed individual improvement over time. Baseline characteristics are shown in Table 1.
Results
126 children were included in this study (63% males, 40% DKA at onset). HbA1c declined from 92 mmol/mol (10.6%) at diagnosis to 55 (7.2%) at 6 months and continued to improve progressively: 54 (7.1%) at 12 months, 54 (7.1%) at 24 months, 52 (6.9%) at 36 months, and 51 (6.8%) at 48 months (n=51). The proportion achieving the ISPAD target of <53 mmol/mol (<7.0%) increased steadily from 46% at 6 months to 57% at 4 years. This improvement was confirmed at the individual level: paired analysis from 12 to 48 months showed a mean decrease of 5.0 mmol/mol (p<0.001), with 67% of children individually improving over time. The continued improvement well beyond the honeymoon period likely reflects increasing caregiver experience and children’s growing ability to participate in diabetes management (mean age at 48 months: 10.1 years, mostly pre-pubertal). Follow-up through puberty will be needed to confirm persistence.
Conclusions
MiniMed 780G initiated at T1D diagnosis in young children achieves progressive, individually confirmed HbA1c improvement through 4 years, with 57% at target by 48 months. These are among the longest real-world follow-up data for AID at onset in pediatrics and support early 780G placement in newly diagnosed children.