Endocrine Abstracts

Introduction: Between June 2023 and February 2024, 161 children and young people (CYP) with Type 1 Diabetes (T1D) were started on the Omnipod 5 automated insulin delivery pump at Leeds Children’s Hospital. Outcomes were analysed for these CYP and provisional findings are presented. As more data becomes available further statistical analysis will be performed; including comparison with other hybrid-closed loop (HCL) systems, enabling the evaluation of outcomes for all CYP on HCL under our care.

Methods: Patient demographics, treatment therapy prior to HCL, glucose metrics, pump settings and any diabetes-related hospital admissions were collected from electronic patient records and manufacturer’s online databases. Pre- and post-HCL glucose metrics were analysed at 3 monthly intervals. Subgroup analysis was performed based on age, sex, ethnicity and index of multiple deprivation (IMD) as well as individual pump settings.

Results: 161 CYP aged between 2 and 21 years of age (average 14.1 years; 81 male, 80 female) were included. The mean glycosylated haemoglobin (HbA1c) of 61.9 mmol/mol prior to HCL fell to 57.2 and 55.3 mmol/mol at 3 and 6 months respectively. The largest fall in HbA1c was seen in patients from black and mixed-race ethnicities; 69.6 reduced to 57.3 mmol/mol and 65.3 to 54.8 mmol/mol respectively at 6 months. HbA1c fell from 68.3 to 57.2 mmol/mol in patients from IMD quintile 1. Patients with an automated mode of 100% (n = 49) had the lowest mean HbA1c at 3 months; 49.4 mmol/mol. Time in range increased from a mean of 49% to 60% and 61% at 3 and 6 months respectively. Time below range reduced from 3% prior to HCL to 1.9% at 6 months. Female CYP saw a larger drop in HbA1c; 64.3 to 54 mmol/mol compared to male CYP; 59.5 to 56.9 mmol/mol at 6 months. 15 patients were admitted to hospital with diabetes-related complications; 5 in diabetic ketoacidosis.

Conclusion: HCL therapy resulted in improvements in glycaemic control, reduced hypoglycaemia and increased TIR for the majority of CYP reviewed. The largest improvements were seen in patients from black and mixed-race ethnicities and those from IMD 1.