P-153: Automated insulin delivery for children and adolescents at onset of type 1 diabetes – a 2-year observational study
M F Truelsen, A Ellermann, N Lind, J Svensson, A G RanjanAbstract
Introduction
Automated insulin delivery (AID) is the most advanced insulin therapy for type 1 diabetes (T1D), yet initiation is often delayed. At Holbæk Hospital, Denmark, AID has been initiated at diagnosis since 2021.
Objectives
To evaluate glycemic and safety outcomes after AID initiation at diagnosis in children and adolescents with T1D.
Methods
This observational study included children and adolescents aged <20 years who initiated AID at T1D diagnosis using the Tandem t:slim X2 pump with Control-IQ technology. Participants were followed for two years. Written and verbal informed consent for data sharing was obtained from participants and parents. Baseline characteristics were recorded at admission. Anthropometric data, continuous glucose monitoring metrics, insulin data, and clinical contacts were collected at week 0, week 1, week 2, week 4, month 3, month 6, month 9, month 12, month 18, and month 24.
Results
In total, 31 individuals newly diagnosed with T1D initiated AID within 2 days after admission. Twelve were female (39%), and 7 presented with mild diabetic ketoacidosis. Median age was 9.2 years (range 1.7–19.5), BMI 15.9 kg/m2 (11.5–36.1), BMI-SDS −0.5 (−4.2 to 7.9), and HbA1c 98 mmol/mol (62–153). Weekly telephone and in-person contacts decreased from a mean (SD) of 4.6 (2.3) in week 1 to 0.5 (0.4) by week 12 and remained low throughout follow-up. HbA1c declined significantly by 3 months to approximately 45.0 (8.0) mmol/mol, with a slight increase after 1 year to 50.4 (13.6) mmol/mol. No readmissions due to severe hypoglycemia or diabetic ketoacidosis occurred during follow-up. Time in range declined after the first month and remained stable in the follow-up period.
Conclusions
Initiating AID at T1D diagnosis in children and adolescents was associated with good glycemic outcomes, with achievement of recommended glycemic targets within months, and no hospital readmissions. These findings suggest that AID initiation at diagnosis is feasible and safe, although larger and longer-term studies are needed.