Endocrine Abstracts

Introduction: Hybrid closed loop pumps (HCL) incorporate insulin pumps (IP) with continuous glucose monitoring (CGM). We reviewed the glycaemic control of patients with Type 1 Diabetes(T1D) cared for at the Evelina who had upgraded from basal bolus regimen or IP to HCL between October 2020 and March 2024.

Method: As per standard care, patients were reviewed in clinic every 3 months and HbA1c was measured, and time in range (TIR) reviewed using CGM data.

Results: Overall, 46 patients had been upgraded, of which 22(47.8%) were males. Median age was 10 years (range 6-16). 27 were on standard insulin pumps and 19 were on basal bolus insulin regimen at the start of HCL. Mean HbA1c values were calculated before and after upgrade and TIR reviewed. The median Hba1c before HCL was 62 mmol/mol with mean of 66.57 mmol/mol and standard deviation (SD) of 17.76%. Mean HbA1c after 90 days of HCL initiation [n = 35] was 57.71+/-12.07 mmol/mol and after 180 days was 55.32 +/-10.14. A single-tailed paired t-test was used to compare the means. When HbA1c before and 90 days after HCL was compared, it showed a p-value of 0.01. There was also a significant improvement in mean Hba1c after 180 days of HCL (p value of 0.001). Mean TIR (%,n = 35) before upgrade was 49.35+/-17.39 and 65.55+/-12.85 after 90 days of HCL. TIR after 180days of HCL was 64.04 +/- 18.08 [n = 28]. There was a significant improvement of time in range with a p-value <0.001 when the mean TIR before and 90 days after HCL was compared. Similarly, when the mean TIR before was compared with TIR after 180 days of HCL, p value was 0.001.

Conclusion: Our review shows a significant improvement in glycaemic control following a switch from a standard IP or basal bolus insulin to a HCL in our paediatric patients with T1D.