Intro: As more diabetes technology is approved for children down to age 2 and off-label use expands, clinical outcomes data for young children on these devices are sparse. We evaluated real-world device usage and the glycemic results in this vulnerable population.
Methods: Retrospective data were collected on all patients with T1D under age 7 years at a large, tertiary care center diabetes clinic (n=230; age 1.1 to 6.8 years). We performed two-sample t-tests by device use (AID vs MDI) for glycemic outcomes (HbA1c, Time in Range 70-180 mg/dL (TIR), Time Below range (TBR) < 70, Time Above Range (TAR) >180 and >250 mg/dL) and insulin dosing parameters. Patients seen in the last 12 months were included.
Results: Use of AID was associated with significantly greater TIR, lower HbA1c, less TBR < 70 mg/dL, and less glucose variability (all p<0.05) (Table 1). Notably, TAR >250 mg/dL was significantly reduced by 9%. AID users have significantly increased total daily insulin use (0.75u/kg/day on AID vs 0.62u/kg units on MDI, p=0.005), but without significant difference in basal to bolus ratios (mean basal 42 to 44% of TDD, p = ns).
Conclusion: In young children with type 1 diabetes at a large clinic, the majority of patients use CGM and AID, but nearly 1/3 do not use AID. Among those using AID, glycemic improvement outcomes were similar to clinical trial results, particularly in minimizing incidence of hyperglycemia and hypoglycemia.
I. Tabatabai: None. G.T. Alonso: Advisory Panel; MannKind Corporation. G.P. Forlenza: Research Support; Abbott, Dexcom, Inc. Consultant; Dexcom, Inc. Research Support; Insulet Corporation. Consultant; Insulet Corporation. Research Support; Medtronic. Advisory Panel; Medtronic. Research Support; Tandem Diabetes Care, Inc. Consultant; Tandem Diabetes Care, Inc.
