P-151: Automated insulin delivery treatment or multiple daily injections early after T1D diagnosis in children and adolescents and the impact on glycaemic control and remission phase: a DPV-registry study
L van der Floe, M Auzanneau, B Karges, J Weekes, S Hofer, V Lahn, J Weiskorn, S Lanzinger, C BoettcherAbstract
Introduction
International guidelines recommend AID-insulin pump therapy for children and adolescents with T1D, with it being the standard of care for those under 6 years old. However, the timing for starting AID therapy after a diabetes diagnosis can vary.
Objectives
We hypothesise that early initiation of AID after diagnosis, compared to multiple daily injections (MDI), leads to better glycaemic control at 6 and 12 months post-diagnosis, and extends the remission phase in children and adolescents.
Methods
We searched the DPV database for individuals with T1D <18 years who were diagnosed and treated with either AID or MDI after diagnosis, between 2022 and 2024, without a change in treatment modality, and who had follow-up data for at least 12 months. Linear logistic regression modelling with inverse probability of treatment weighting, accounting for age, sex, BMI, DKA at diagnosis, and migrant background as influencing factors, was used. HbA1c values served as a measure of glycaemic control, and insulin-dose-adjusted A1C (IDAA1C) as a marker for partial remission.
Results
The table shows the population’s baseline characteristics within 4 weeks of diabetes diagnosis. After 6 and 12 months of therapy, mean HbA1c-values were lower in AID-persons compared to MDI-persons: 6.26 ± 0.06 % (6 months) and 6.38 ± 0.09 % (12 months) vs 6.70 ± 0.02 % (6 months) and 7.04 ± 0.03 % (12 months) (p < 0.0001, respectively). IDAA1C was and remained lower under AID compared to MDI: 8.86 ± 0.13 and 8.76 ± 0.13 for 6 and 12 months in AID vs 9.42 ± 0.05 and 10.06 ± 0.07 (p < 0.0001, respectively).
Conclusions
Starting AID insulin pump therapy early after T1D diagnosis leads to better glycaemic control at 6 and 12 months of diabetes duration in children and adolescents, and to better, longer-lasting remission. This might be important for the development of diabetes-related complications later in life.