Endocrine Abstracts

Introduction: At our centre, we adopted a hybrid virtual flipped learning model to onboard children with type 1 diabetes onto hybrid closed-loop (HCL) systems. This approach doubled staff capacity, facilitating a five-fold increase in onboarding. We achieved a 16% improvement in time in range (TIR, 3.9-10.0 mmol/l) and aimed to evaluate absolute glucose levels post-HCL across minioritised groups.

Objectives: Evaluate absolute glycaemic control among different ethnic and socioeconomic status (SES) groups over the first 90-days of HCL system use.

Methods: Retrospective analysis (2019-2024) of CYP transitioning from CGM to HCL. Data on demographics and glucose metrics were collected from patient records and manufacturer’s online databases, excluding those with less than 50% data capture. 90-day CGM data pre and post HCL were compared between different ethnic and SES groups.

Results: A total of 169 CYP (53% male) with a mean age of 12.4 (±3.6) years and T1D duration of 6.0 (±3.7) years were included. The majority (n = 95/56%) were of non-white ethnicity [South Asian (SA),n = 59, 35%; Black (B),n = 26, 15%; White (W)n = 74, 44%]. A third each were most deprived (T1,n = 56/33%), second most deprived (T2,n = 56/33%) and least deprived (T3,n = 57/34%). 20 (12%) CYP required an interpreter. At baseline; W, SA and B had comparable time below range (TBR, <3.9 mmol/l) (1.5%, 2.4%, 2.8%, P = 0.053), TIR (48%, 48%, 45%, P = 0.499), and mean blood glucose (MBG mmol/l) (10.7, 10.7, 11.0, P = 0.716) respectively. After 90-days of HCL; W, SA and B had comparable TBR (1.9%, 1.9%, 2.6%, P = 0.169), TIR (65%, 65%, 63%, P = 0.519), and MBG mmol/l (9.2, 9.1, 9.3, P = 0.587) respectively. At baseline, T1, T2 and T3 had similar TBR (2.6%, 1.6%, 2.2%, P = 0.51), TIR (47%, 47%, 50%, P = 0.300), and MBG mmol/l (10.8, 10.9, 10.5, P = 0.417) respectively. After 90-days of HCL, there were no significant differences for TBR (2.2%, 1.9%, 1.9%, P = 0.531), TIR (65%, 64%, 67%, P = 0.154), and MBG mmol/l (9.2, 9.3, 9.0, P = 0.177) across T1, T2 and T3 respectively.

Conclusions: Equitable onboarding to HCL systems through innovative educational methods achieves comparable glycaemic improvements in children with type 1 diabetes from diverse ethnic and socioeconomic groups.