Introduction & Objectives: Automated insulin delivery (AID) systems can improve HbA1c in people with type 1 diabetes (T1D). Data are limited on rates and impact of discontinuation of newer AID in the emerging adult population.

Methods: Retrospective chart review was performed on 14-30 year olds with T1D of ≥ 1 year duration, started on an AID system (Medtronic 770G, Control-IQ, Omnipod 5) after 2018. HbA1c prior to and quarterly for 24 months after initiation were collected. Discontinuation of AID (≥ 1 visit without use) was noted. Mixed model was fit for HbA1c values and time, adjusting for age, sex, diabetes duration, race/ethnicity, and insurance. Contrasts generated to compare HbA1cs at each time point.

Results: In 613 emerging adults with T1D (mean age 21.1±4.2 years, diabetes duration 10.8±6.0 years, male 44.5%, non-Hispanic White 76.8%), 3109 HbA1c values were collected. Mean HbA1c decreased from 8.5% at baseline to 7.7% by 24 months (p<0.001). Discontinuation was associated with higher HbA1c (p<0.001). AID was discontinued at least temporarily by 15.3% of patients (N=94), with highest rates in 19-22 year olds (38 of 174, 21.8%). AID discontinuation reasons included supply (25.5%) or cost/insurance issues (15.3%).

Conclusion: Consistent AID usage in emerging adults is associated with sustained improvements in HbA1c levels. Further study on strategies to reduce discontinuation is required.

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Disclosure

L.A. Waterman: None. E.C. Cobry: Advisory Panel; Dexcom, Inc. Other Relationship; Dexcom, Inc. C. Sakamoto: None. L. Pyle: None. 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. V.N. Shah: Consultant; Dexcom, Inc., Insulet Corporation. Research Support; Insulet Corporation. Advisory Panel; Novo Nordisk. Research Support; Novo Nordisk. Advisory Panel; Sanofi, Medscape. Consultant; embecta, Tandem Diabetes Care, Inc. G.T. Alonso: Advisory Panel; MannKind Corporation.

Funding

National Institutes of Health (5T32DK063687)

© 2024 by the American Diabetes Association
2024
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