P-340: Glycemic outcomes at 30 and 90 days after automated insulin delivery initiation in children and adolescents with type 1 diabetes: a Brazilian real-world study
M Gabbay, L E Calliari, M Scharf, S Viegas Chen, M Punales, P Amaral Fulgencio da Cunha Menezes, P Cole Brugnera Caddah, I Van der Linder, R SiqueiraAbstract
Introduction
Automated insulin delivery (AID) has improved glycemic outcomes in pediatric type 1 diabetes in clinical trials, but real-world evidence from middle-income countries remains limited.
Objectives
To evaluate early glycemic outcomes after AID initiation in children and adolescents with type 1 diabetes in routine clinical practice.
Methods
We conducted a retrospective observational real-world study including 41 children and adolescents (<18 years, 12.7±3.3 years), with type 1 diabetes initiating AID (baseline: manual mode) and follow-up after 30 and/or 90 days of AID. Outcomes included time in range (TIR, 70–180 mg/dL), time above range (TAR >180 mg/dL and >250 mg/dL), time below range (TBR <70 mg/dL and <54 mg/dL), and coefficient of variation (CV).
Results
Forty-one children/adolescents had paired baseline and 30-day data, and 19 had paired 90-day follow-up. Mean TIR improved significantly from 61.0% at baseline to 74.1% after 30 days of AID (+13.1 %; p<0.001) and 90-day from 64,5% to 71% (+6,5%; p<0.001). Time spent in hyperglycemia improved, with TAR >180 mg/dL decreasing from 37.4% to 23.6% (p<0.001) and TAR >250 mg/dL from 13.4% to 7.9% (p<0.001). CV%, TBR<70 and TBR< 54mg/dL did not change (respectively: 37.0% to 38.0%; p=NS; 1.6% to 2.2%; p=NS, and 0.34% to 0.40%; p=0.06). Among participants with 90-day follow-up, glycemic benefit was sustained, with TIR increasing from 64.5% to 71.0% (p<0.001), without evidence of increased hypoglycemia.
Conclusions
In this Brazilian real-world pediatric cohort, AID was associated with rapid and clinically meaningful improvement in glycemic control, sustained at 90 days, without increased clinically significant hypoglycemia.