Introduction & Objective: Glycemic outcomes in youth with T1D have not been compared between the two most commonly used AID systems in the United States, Insulet Omnipod 5 (OP5) and Tandem Control IQ (CIQ). Our aim is to perform the first head-to-head analysis of changes in TIR in youth initiating AID systems to further support clinical counseling and decision making.

Methods: This single center, retrospective chart review included youth < 21 years who were prescribed OP5 or CIQ between 2022-2023. AID start dates, pump data, 14-day baseline and 90-day continuous glucose monitor data were obtained from proprietary cloud-based software. A multiple linear regression model assessed for differences in 90-day time in range (TIR) according to AID system initiated.

Results: Among 470 youth, 228 (48.5%) started OP5 and 242 (51.4%) initiated CIQ. OP5 users were more likely to identify as female (57.5% vs 47.1%, p=0.03) and non-Hispanic Black (15.4% vs 4.5%, p=<0.01). OP5 users had a shorter TID duration (1.7 [IQR 0.7, 4.4] vs. 5.9 [IQR 2.9, 5.9], p=<0.01) and were more likely to have transitioned to AID from multiple daily injections (76.8% vs 19%, p<0.01). Baseline TIR was similar between groups (OP5 51.0% [IQR 36.3, 67.4] vs CIQ 52.9% [IQR 39.3, 66.3], p=0.74). There was no difference in AID active time (OP5 89.6% vs CIQ 87.4%, p=0.10) or user-initiated boluses per day (OP5 5.0 vs CIQ 5.3, p=0.21). 90-day TIR increased in both groups (p<0.001), rising by 11.9%-points (95% CI [10.3,13.4]) in OP5 users and 9.9%-points (95% CI[8.4,11.5]) in CIQ users. After adjusting for sex, race/ethnicity, T1D duration and prior regimen, improvements in 90-day TIR did not differ between AID systems (p=0.11).

Conclusion: Improvements in 90-day TIR following AID initiation among youth with T1D are significant and do not differ between commonly prescribed systems. Further studies are required to understand patient-related factors that may lead to differential success with a particular AID system.

Disclosure

S. Gera: None. A. Rearson: None. G. Baker: None. J.L. Douvas: None. N. Alicea-Trelles: None. R.J. Gallop: None. S. Meighan: Speaker's Bureau; Dexcom, Inc. B.E. Marks: Research Support; Tandem Diabetes Care, Inc., Dexcom, Inc., Medtronic, Digostics. Advisory Panel; International Society for Pediatric and Adolescent Diabetes, American Diabetes Association, T1D Exchange. Board Member; Juvenile Diabetes Research Foundation (JDRF).

© 2024 by the American Diabetes Association
2024
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