P-256: Patch-based automated insulin delivery improves glycemic control in pediatric type 1 diabetes: real-world 6-month data
M L Kabakian, A Flores, S Carbajal, A Portnoy, F Baldi, F Oliva, R Carnero, D ContrerasAbstract
Introduction
Automated insulin delivery (AID) systems are transforming type 1 diabetes (T1D) care.
Objectives
To evaluate the effectiveness of a patch-based AID system in children and adolescents with T1D.
Methods
Multicenter retrospective study including 90 patients aged 2–18 years initiating AID therapy using the Nanotouch Care A8 patch system. Patients were stratified into age groups (2–6, 7–12, and 13–18 years). Glycemic metrics were assessed at baseline, 1, 3, and 6 months, including time in range (TIR 70–180 mg/dL), time in tight range (TTIR 70–140 mg/dL), time below range (TBR), time above range (TAR), HbA1c, mean glucose, and coefficient of variation (CV). Paired t-test or Wilcoxon signed-rank test were used as appropriate.
Results
Mean age was 12.1±3.5 years, with 56.7% female participants. TIR increased from 55.8% to 71.0% at 6 months (p<0.001), achieving international targets. HbA1c decreased from 7.83% to 7.06% (p<0.001), and mean glucose from 174.1 to 155.8 mg/dL (p<0.001). Coefficient of variation decreased, indicating reduced glycemic variability. TAR decreased from 24.8% to 18.9% (p<0.001), and TBR from 2.29% to 1.62% (p=0.01). Severe hyperglycemia (>250 mg/dL) decreased from 15.4% to 8.1% (p<0.001). TTIR remained ∼47%. Improvements were consistent across age groups (p>0.05). Automode use >94%, and severe adverse events were infrequent (3.4%), primarily associated with delayed response to system alerts (e.g., occlusion or calibration requests).
Conclusions
Patch-based AID showed significant, rapid, and clinically meaningful improvements in glycemic control, with high adherence and a favorable safety profile across pediatric age groups, supporting its role as a practice-changing technology in pediatric T1D care.