P-412: Pediatric type 1 diabetes on insulin pump therapy in Brazil’s public health system: demographic, clinical and glycemic profile from the federal district
R Pereira Ribeiro, G Vieira Ferreira Guimarães, R K Menezes Maciel Falleiros, F Franca Melo, M D Reis Borba, L Garcia Miranda, T Cabral Gomes Lauand, H Cordeiro PedrosaAbstract
Introduction
Real-world data on insulin pump therapy for pediatric type 1 diabetes within Brazil’s public health system are scarce.
Objectives
To describe the demographic, clinical and epidemiological profile of children and adolescents with type 1 diabetes using continuous subcutaneous insulin infusion in the public health system of the Federal District, Brazil.
Methods
This retrospective cross-sectional observational study reviewed electronic medical records of patients followed at the insulin pump outpatient clinic of the Endocrinology Unit, Hospital Regional de Taguatinga, between January and December 2025. Patients aged under 18 years with type 1 diabetes using automated or non-automated pump therapy and receiving all supplies through the public health system were included. Variables analyzed were age, age at diagnosis, diabetes duration, pump modality, HbA1c, time in range (70–180 mg/dL), time below range (<70 mg/dL), time above range, and diabetic ketoacidosis requiring hospitalization. Descriptive analysis was performed.
Results
Thirty-four patients were evaluated, with a mean age of 8.8 years. Diabetes duration ranged from 2 to 9 years. Diagnosis occurred before 5 years of age in 76.4% and before 2 years in 65.3%. Mean pump use duration was 3.44 years. Mean time in range was 55.0%, mean time below range was 4.3%, and mean time above range was 40.7%. Diabetic ketoacidosis requiring hospitalization occurred in 8.8%. Mean HbA1c was 7.68% among 32 patients with available data.
Conclusions
This cohort showed very early-onset type 1 diabetes and substantial management complexity. The findings support the feasibility of pump therapy within the Brazilian public health system, particularly in young children, although additional strategies are needed to improve time in range.