Introduction & Objectives:Use of automated insulin delivery (AID) systems can improve HbA1c in people with type 1 diabetes (T1D). Data are limited on the impact in emerging adults with higher baseline HbA1cs.

Methods:Retrospective chart review performed on 14-30 year olds with T1D ≥ 1 year duration, started on advanced AID systems (Control IQ, Medtronic 770G, Omnipod 5) after 2018. HbA1c at baseline and at 3 month intervals (max 24 months) following AID initiation were collected. 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. Participants were categorized by baseline HbA1c (<7%, 7-9% and >9%).

Results:HbA1c values (N=3137) were collected from 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%). Mean HbA1c changed from 11.2% to 9.2% (baseline and 24 months) for HbA1c >9% (N=190); 8.3% to 7.9% for HbA1c 7-9% (N=314); and 6.5% to 6.8% for HbA1c <7% (N=109) (all p<0.001). The percent with HbA1c <7% improved from 17.9% at baseline to 32.2% and 34.2% (3 and 24 months).

Conclusion:AID initiation is associated with sustained improvements for those not initially meeting glycemic targets, particularly those with the highest HbA1cs. As most remained above target, additional strategies for improvement are required.

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Disclosure

L.A. Waterman: None. G.T. Alonso: Advisory Panel; MannKind Corporation. 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. E.C. Cobry: Advisory Panel; Dexcom, Inc. Other Relationship; Dexcom, Inc.

Funding

National Institutes of Health (5T32DK063687)

© 2024 by the American Diabetes Association
2024
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