P-254: Adapting to changing insulin needs in youth with type 1 diabetes: a Real-World analysis of a tubeless automated insulin delivery system
J Sherr, J Boyd, L Huyett, D Do, T LyAbstract
Introduction
Insulin needs in children with T1D are variable due to growth/development, illness, activity, and dietary changes. Achieving optimal glycemia while avoiding hypoglycemia is challenging and often requires dose adjustments.
Objectives
To assess the Omnipod 5 System’s ability to safely and autonomously adapt to changing insulin needs in real-world youth with T1D.
Methods
A retrospective analysis of CGM and total daily insulin (TDI) data was conducted in youth (2-17y) with T1D using Omnipod 5 in the US, Europe, Canada, and Australia with sufficient CGM data (≥50% of days with CGM readings and ≥75% of those days with ≥220 readings). A decreasing insulin-need event began when TDI fell below a person’s baseline TDI (the day prior) and remained below for ≥28 consecutive days. Events ended at the earliest of: 1) TDI crossing back over baseline; 2) if follow-up extended beyond 91 days from event start, the first day TDI exceeded its value 91 days earlier; or 3) analysis end. Included events had ≥25% variance from baseline TDI. Outcomes were summarized for the 30 days pre-event and from event start to lowest TDI. The same process was applied to TDI increases.
Results
Among 175,138 youth using Omnipod 5 with changing insulin-need events: 86,284 had a TDI decline and 88,854 had a TDI increase. For declining TDI events, median TDI was 45.7 U/day the day before event start and reduced to 28.8 U/day at its lowest point. For increasing TDI events, TDI was 33.4 U/day the day before event start and increased to 57.2U/day at its highest point. These insulin changes were associated with minor changes in time in range while time below range remained low (Table).
Conclusions
The Omnipod 5 System demonstrated the ability to safely adapt to changing insulin needs, maintaining strong time in range and low hypoglycemia without requiring substantial setting changes, reducing the burden of manual dose and setting adjustments in youth with T1D.