Long-Term Glycemic Outcomes in Pediatric Type 1 Diabetes: A 2-Year Real-World Analysis of Different Automated Insulin Delivery Systems Generations
Authors' conclusion
AID systems improve key glycemic outcomes and reduce hypoglycemia compared with prior therapies. Noncalibration systems demonstrate superior performance over time. However, the initial HbA1c benefits wane after the first year, highlighting the need for strategies to sustain long-term metabolic improvements.
Study context
- Population
- CwD under 20 years switching from MDI, CSII or predictive low glucose management to automated insulin delivery (AID), 2019–2022
- Participants
- 305 participants
- Exposure
- Noncalibration AID systems vs calibration-requiring 670G
- 670Gn = 83reference
- Noncalibration systemsn = 222
- Outcome
- HbA1c
- Follow-up
- 24 months
Methodological detailsmonocentric, real-world
- Monocentric
- Real-world
Main finding
As reported in the abstract
P = 0.021
Observational data: associations, not effects.
Further findings
TDD · 24 months · reduced with noncalibration systems
P = 0.022
Time in automated mode · 24 months · greater with noncalibration systems
P < 0.001
Time in range (TIR), TAR (181-250 mg/dL), TBR (<54 mg/dL), mean glucose and glycemia risk index (GRI) after AID start, all groups
- Significant improvements with AID use
- all P < 0.001
Hemoglobin A1c (HbA1c) over time, all groups · first and second year
- HbA1c declined in first year but regressed toward baseline in second year
- P < 0.001
Predictors of 24-month HbA1c
- Baseline HbA1c, AID type and age were significant predictors
- Multiple linear regression
Original publication
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