Introduction & Objective: DKA at T1D diagnosis is associated with higher HbA1c in subsequent years. We aimed to study whether AID systems used within a week after starting insulin can modify glycemic control over time.
Methods: AID were introduced in Italy during 2019 and 2020. In this cohort study, 825 patients aged <18 yrs with T1D diagnosed between 2019-2020 were followed in 2021 and 2022 by 25 pediatric centers. At diagnosis and for each subsequent year HbA1c, use of CGM, IP, or AID, TIR, no. of severe hypos and DKA were collected. Student-t test or Fisher exact test were used to compare groups. Logistic Regression was used to estimate basal factors associated to glycemic target evaluated in 2022.
Results: Children with DKA at onset (40.1%, 95%CI 36.8-43.6) were younger (9.3 vs 10.2 yrs, p=0.009) and had higher HbA1c (12.1 vs 11.1, p<0.001). AID at diagnosis were used in a small number of patients (n=29). No differences were found in the use of CGM, IP, or AID, no. of hypos and DKA events between those with DKA at onset or not. The probability of having glycemic control at target at the 2022 visit is shown in table 1.
Conclusion: AID at the diagnosis of T1D seem useful for improving glycemic control in the following years regardless of DKA, HbA1c at onset and gender. Long-term studies will clarify whether the timely use of AID can improve glycemic outcomes of children with DKA at onset.
V. Cherubini: None. S. Santarelli: None. R. Gesuita: None.
