P-363: Real-world glycemic outcomes after transition from multiple daily injections to insulin patch pump therapy in children with type 1 diabetes

Introduction

The incorporation of technologies for management of type 1 diabetes (T1D) has transformed the assessment and optimization of glycemic control in children and adolescents. Continuous insulin infusion (CSII) therapy has demonstrated benefits over multiple daily insulin injections (MDI)

Objectives

Describe the changes in metrics derived from continuous glucose monitoring (CGM) following the transition from MDI to Patch Pump in children with DM1 during the first three months of treatment.

Methods

Observational, retrospective, single-center study. Included 6 children with DM 1 who transitioned from MDI to a Patch Pump in the Diabetes Center, who had complete CGM records during the three months prior to and after the start of therapy.

All of them used the same system during both periods. Time in range (TIR 70–180 mg/ dL) time under range (TBR <70 mg/ dL) coefficient of variation (CV), and glucose management indicator (GMI) were analyzed.

Results

Children with DM1 were included. After the transition to a Patch Pump showed an increase in TIR from 52.0% (IQR 46.0–52.8) to 64.9% (IQR 59.0–69.7), with an absolute difference of +14.4 percentage points (p=0.063), equivalent to approximately 3.5 additional hours per day in the target glycemic range.

The GMI showed reduction: 7.6% (IQR 7.5–7.9) to 7.25% (IQR 6.9–7.45) (p=0.125). No relevant changes were observed in the metrics related to glycemic safety: TBR remained stable (1.0% [IQR 0–3.3] vs. 1.3% [IQR 0.7–2.7]; p=1.000) and CV showed no significant modifications (37.3% [IQR 35.6–43.4] vs. 39.5% [IQR 38.3–40.8]; p=1.000).

Conclusions

In this initial real- word experience, the transition from MDI to Patch pump therapy was associated with a clinically improvement in glycemic control, an increase in the TIR and a reduction in the MG, without an increase in exposure to hypoglycemia. These results provide preliminary evidence for the implementation of this technology in the pediatric population and justify prospective studies with larger sample sizes and longer follow-up.