Teens with Type 1 Diabetes and Executive Function Challenges Who Use Insulin Pumps Have Lower A1C Without Increased Risk of Diabetic Ketoacidosis or Severe Hypoglycemia
Authors' conclusion
Despite occasional prescriber hesitancy, teens with type 1 diabetes and EF challenges using insulin pumps had lower A1c without increased DKA risk compared with nonpump-users.
Study context
- Population
- Teens with T1D, with or without executive function (EF) challenges (parent-reported Behavior Rating Inventory of Executive Function)
- Exposure
- Insulin pump use vs nonuse, by presence/absence of EF challenges
- Outcome
- A1c in teens with EF challenges
Methodological detailsprospective collection of severe hypoglycemia (SH) and diabetic ketoacidosis/hyperglycemia (DKA) events, adjusted multivariable models, Poisson regression
- Prospective collection of SH and DKA events
- Adjusted multivariable models
- Poisson regression
Main finding
As reported in the abstract
P = 0.009
Observational data: associations, not effects.
Further findings
| Outcome | Difference (%) | P value |
|---|---|---|
| A1c in teens with EF challenges (by one index), multivariable analysisLower with pump-users · multivariable analysis | 0.65 | P = 0.028 |
A1c in teens without EF challenges
- No A1c differences by pump use/nonuse in those without EF challenges
Safety
DKA incidence, all teens · lower with pump-users
P = 0.012
DKA incidence in teens without EF challenges · lower with pump-users
P = 0.003
SH incidence
- SH incidence did not differ by pump use or EF status
DKA incidence by EF status
- DKA incidence lower in teens without than with EF challenges (4.9 vs. 14.0/100-person-years)
- P = 0.012
DKA incidence in teens with EF challenges
- DKA incidence rates (IRs) did not differ by pump use in those with EF challenges
Original publication
Teens with Type 1 Diabetes and Executive Function Challenges Who Use Insulin Pumps Have Lower A1C Without Increased Risk of Diabetic Ketoacidosis or Severe Hypoglycemia. Diabetes Technol Ther. Published 6 February 2025. doi:10.
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