134-OR: The Safety and Efficacy of Virtual Insulin Pump Initiation in Children and Adolescents with Type 1 Diabetes in the United States

Introduction & Objective: This study aimed to determine the safety and efficacy of virtual insulin pump initiation compared to in-office insulin pump initiation resulting from the COVID-19 pandemic lockdown.

Methods: A longitudinal retrospective study of 112 subjects. Sixty-five percent (n=73), ages 11.2 ± 3.8 years, received in-office training, and 35% (n=39), ages 12.0 ± 4.0 years, received virtual training. Anthropometric, glycemia, and demographic data were collected at insulin pump initiation, 3 and 6 months.

Results: There were no differences in sex, race in the two groups. There were no differences in height, weight, BMI, A1c, and the duration of diabetes between the two groups at 0, 3, and 6 months. A1c and the glucose management indicator (GMI), correlated significantly at all time points. When subjects were stratified by sex, race, age into <10 years and >10 years and by normal-weight (BMI of <85^th percentile) or overweight or obese (BMI of ≥85^th percentile), there was no difference in A1c and TIR. There was equally no relationship between age at pump initiation and BMI. However, the comparison between A1c and TIR among the races, Whites (n=61) versus non-Whites (n=44), showed a significantly elevated A1c in the non-White group at 6 months only: [7.45% (6.8-8.5) versus 6.9% (6.4-7.6)], p = 0.007.

Conclusion: Virtual insulin pump initiation may be safe and effective in children and adolescents with type 1 diabetes. This approach could bridge the gap in the adoption of diabetes technology in the minority population in the US.