P-268: Real-world data from a digital health platform: population profile and glycemic outcomes in Brazilian youth with type 1 diabetes
K F S Melo, M Barone, L E P Calliari, M Scharf, G D Ogle, J Nieri, K SantoAbstract
Introduction
Real world data of glycemic outcomes in children and adolescents with Type 1 diabetes (T1D from low- and middle-income countries remain limited. In Brazil, there are few studies published with large-scale real-world data. Digital health platforms offer an opportunity to generate population-level insights.
Objectives
To describe the epidemiological profile, insulin prescription patterns, and glycemic outcomes of children and adolescents with T1D in Brazil using real-world data from a digital health platform, and to identify factors associated with glucose in range.
Methods
Cross-sectional retrospective study using anonymized digital self-management data from individuals ≤20 years with self-reported T1D. Variables included sociodemographic, clinical, prescription, and glycemic measures; factors associated with glucose in range (70–180 mg/dL) were assessed.
Results
4,514 children and adolescents (11.1±5.6 years; 55.6% female), mostly from the Southeast (57.7%). Mean diabetes duration was 3.0±3.9 years. Long-acting and short-acting insulin analogs predominated; mean total daily insulin dose 1.0±0.3 units/kg/day. Mean 24-hour glucose was 187.7±81.9 mg/dL: 52.9% in range, 45.5% above range, 1.6% below. Geographic region was associated with glycemic outcomes (p=0.003), with higher proportion of dysglycemia in the South. Glucose in range was associated with younger age, shorter diabetes duration, use of ultra-long and ultra-short acting insulin analogs, and higher insulin doses (p<0.05). Platform engagement varied, with 24.3% were highly active users.
Conclusions
This study represents the largest real-world dataset of children and adolescents with T1D in Brazil derived from a digital health platform. Glycemic outcomes remain suboptimal, with marked regional disparities and less than two-thirds of glucose values within target. Digital platforms can generate scalable evidence to inform clinical and policy decisions. Addressing geographic inequities should be a priority to improve outcomes in pediatric diabetes care.