P-260: Impact of continuous subcutaneous insulin infusion on glycemic control in children and adolescents with type 1 diabetes mellitus
R Sant’Ana Alves, G de Carvalho Kraemer, C da Cunha Assis Almeida, C Oliveira de Paulo, F Bora Moletta, A Leão, S Nesi FrançaAbstract
Introduction
Type 1 diabetes mellitus (T1D) in children and adolescents requires intensive insulin therapy to achieve optimal glycemic control. Continuous subcutaneous insulin infusion (CSII) has been increasingly used to improve metabolic outcomes.
Objectives
This study aimed to evaluate the impact of CSII on glycemic control in pediatric patients with T1D.
Methods
This retrospective, longitudinal, observational study included children and adolescents (0–18 years) with T1D followed at the Pediatric Endocrinology Service Professor Rômolo Sandrini, Hospital de Clínicas, Federal University of Paraná (CHC-UFPR), Brazil, between 2014 and 2025. Patients using Medtronic® CSII systems with at least 6 months of follow-up before and after CSII initiation were included. Clinical and laboratory data, including HbA1c and continuous glucose monitoring metrics, were collected. Statistical significance was set at p<0.05.
Results
A total of 41 patients were included (61% female), with a median age at diagnosis of 5 years and a median diabetes duration of 4 years prior to CSII initiation. HbA1c decreased from 8.5±1.3% to 7.7±0.9% at 6 months (p<0.001), remaining stable up to 24 months; 80.8% of patients showed HbA1c reduction at 6 months. Median time in range (TIR) was 60.5% at 3 months and 62.0% at 6 months, with low and stable time in hypoglycemia. Among MiniMed 780G® users, HbA1c improved from 8±1.1% to 7.4±0.7% (p=0.011), with a median TIR of 68.3%. Transition from MiniMed 640G® to 780G® was associated with increased TIR (54% to 68.4%; p=0.078) and a reduction in HbA1c (8.8±1.5% to 8.0±0.5%; p=0.437), without a clinically relevant increase in hypoglycemia.
Conclusions
CSII was associated with significant and sustained improvements in glycemic control in children and adolescents with T1D, particularly within the first six months, without an increase in hypoglycemia. Advanced hybrid closed-loop systems provided additional gains in glycemic outcomes, supporting their role in optimizing diabetes management in the pediatric population.