Diabetic Retinopathy Outcomes and Early Worsening of Diabetic Retinopathy in Adolescents and Young Adults With Type 1 Diabetes Following Rapid and Large Glycemic Improvements After Commencing Automated Insulin Delivery
Authors' conclusion
Automated insulin delivery is associated with substantial glycemic improvement in adolescents and young adults with T1D. Despite these large glycemic improvements, diabetic retinal disease remains stable or improves in most cases. Risk factors for deterioration include age >18 years and preexisting DR.
Study context
- Population
- Adolescents and young adults with T1D (aged 10–30 years) and hemoglobin A1c (HbA1c) ≥ 8.5% (69 mmol/mol) prior to automated insulin delivery (AID) initiation; mean age 17.8 years, diabetes duration 9.7 years, 54.7% female, baseline HbA1c 10.3% (89.5 mmol/mol)
- Participants
- 95 adolescents
- Outcome
- DR outcomes, including EWDR, following AID initiation
- Follow-up
- At least three months after AID initiation
Main finding
As reported in the abstract
DR outcomes after AID initiation
Retinopathy remained stable or improved
72 of 95
75.8%
Early worsening of diabetic retinopathy (EWDR) inclusive of diabetic macular edema (DME)
23 of 95
24.2%
Observational data: associations, not effects.
Further findings
HbA1c change
- Mean HbA1c improved after AID initiation
- 2.1 percentage points (22.6 mmol/mol)
Risk factors for EWDR (logistic regression)
- Age >18 years and preexisting retinopathy at AID initiation were the only significant risk factors for EWDR
Safety
- Proliferative diabetic retinopathy (DR) requiring treatment
- three participants (3.2%)
- No one required treatment for DME
- All had preexisting retinopathy and ≥1 additional diabetes-related complication/risk factor
Original publication
Diabetic Retinopathy Outcomes and Early Worsening of Diabetic Retinopathy in Adolescents and Young Adults With Type 1 Diabetes Following Rapid and Large Glycemic Improvements After Commencing Automated Insulin Delivery. J Diabetes Sci Technol. Published 11 May 2026. doi:10.
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