Endocrine Abstracts

Background: Advances in insulin pumps and continuous monitoring mean that, where indicated sensor augmented pump therapy (SAPT) can be prescribed for children under NHS care in England. National Paediatric Diabetes Audit (NPDA) data shows improved diabetes outcomes (in terms of HBA1c) in children managing their diabetes in this way. Use of this technology is significantly lower in children in the lower deprivation quintiles and in patients from non white ethnicity, both whom have higher HBA1c. It is uncertain whether the outcomes seen in the NPDA are due to the technology or to other social and educational factors.

Design: As a unit with significant deprivation (48% patients are in quintile 1) and high levels of patients of non white ethnicity (28%), East Lancashire was awarded funding to improve the uptake of technology. Families were invited to a technology roadshow. Subject to meeting NICE criteria, patients were offered a choice of 3 pumps – Omnipod +Dexcom G6 (non SAPT at time of pump start), T Slim with Control IQ (SAPT) and Yposmed pump with CAMAPS (SAPT). Full training and follow up were provided for all patients. Outcomes including time in range, and episodes of diabetic ketoacidosis were tracked pre and post intervention.

Results: 31 Patents were commenced on pump therapy:11 patients had HBA1c>69 mmol/mol pre pump. Average HBA1c in this group fell from 82.1 mmol/mol pre to 62.71 mmol/mol post. For those on sensor augmented pump therapy in this group the reduction was from 81 mmol/mol to 60.4 mmol/mol. One patient discontinued pump therapy however there were no episodes of DKA.

Conclusion: SAPT resulted in improvements in time in range in patients from deprived and non white backgrounds with high HBA1c compared with non SAPT technology. In this group it was safe and effective. SAPT should be considered as an option in these patients and actively offered.