Endocrine Abstracts

Introduction: Glucose monitoring and administration of insulin are critical components of type 1 diabetes management in children. Increasingly, technology such as continuous glucose monitors (CGMs) and insulin pumps are being used in a ‘closed loop’ system to effectively manage diabetes in children.

Aim: To evaluate the impact of a closed loop system via the Omnipod 5 pump and Dexcom G6 CGM system on glycaemic control in a cohort of children at South Tees Hospitals NHS trust.

Methods: A review of electronic patient records was undertaken. 108 children aged 0-18 years in the paediatric diabetes service within South Tees Hospitals had commenced a closed-loop system with Omnipod 5 and Dexcom G6 between July 2023 and March 2024, with an average duration from diagnosis of 46 months (IQR 17-67 months). HbA1c and time-in-range (TIR) was recorded at introduction of the closed loop system as well as 3-month and 6-month intervals.

Results: Mean HbA1c and TIR at commencement were 59 mmols/mol (IQR 51-65) and 54% (IQR 41%-65%) respectively. At 3 months these had improved to 55 mmols/mol (IQR 51-60) and 64% (IQR 58%-70%). At 6 months, 94 patients had recorded data showing a mean HbA1c of 56 mmols/mol (IQR 50-60) and TIR of 64% (IQR 57%-71%). Only one child had to stop using the pump due to local skin reaction. Prior to this switch, 77 (71%) of the children were already using an Omnipod pump, 28 patients (26%) were using multiple daily injections, and 2 patients were on other closed loop systems (2 on Medtronic and 1 child on T-slim). For monitoring, 104 children were already using Dexcom G6, 2 were using a Guardian sensor, 1 patient was using Libre 2 and 1 patient was on Dexcom G7.

Discussion: Initiation of a closed loop system via Omnipod and Dexcom G6 was associated with a mean improvement in HbA1c and TIR within a 3-month period for our patients which has been maintained at their 6-month review. Subgroup analysis is underway to evaluate cohorts of interest, including those with a high Hba1c. We also aim to collect patient feedback about their views on the closed loop system.