ESPE Abstracts

Introduction: Assessment of real-world use of diabetes technology recently introduced in the region can provide information on clinical outcomes to help with advancement of care in a developing country like Egypt.

Objectives: This prospective pilot study included patient-reported clinical outcomes on glycemic metrics in pediatric and adolescent patients with T1DM before (baseline) and 12 weeks after (follow up) the initiation of a tubeless insulin pump (Omnipod DASH® Insulin Management System) previously treated with multiple daily injections and monitored by FreeStyle Libre, flash glucose monitor (FGMS; Abbott, Alameda, California).

Methods: Data captured during study period were aggregated and analyzed. Percentage of time spent within (TIr= 70–180 mg/dl), below (TBR) and above (TAR) glycemic ranges, mean glucose management indicator (GMI), total daily dose (TDD) and frequency of adverse events in users with 14 or more days of sensor glucose data were determined. Baseline and follow-up visits were carried out for assessment of outcomes.

Results: Patients (n=28) aged 9.4±3.7yrs and 64.3% were males. When compared with pre-pump initiation (MDI therapy); time in range significantly increased from 61.6% at baseline to 73.2 %(P<0.001). Time above range (for both >180 mg/dL and time >250 mg/dL) significantly decreased from 39.2% to 24.7% (P < 0.001), while time below range (for both <70 mg/dL and time <54mg/dL) significantly decreased from 7.4% to 2.6% (P < 0.001). Mean glucose levels were reduced from 169.5 mg/dL at baseline to 143.7 mg/dL (P < 0.001) at last visit. Coefficient of variation (%) decreased from 49.4% to 35.5%. Significantly improved glycemic control was observed as GMI was reduced by 0.9% ± 0.4% while there was a reduction in TDD of insulin of -5.2±7.8 U/d (P<0.01) and mean bolus frequency was 4.8 times per day. No episodes of severe hypoglycemia or DKA were reported.

Conclusions: Real-world data document that tubeless insulin pump therapy is associated with clinically meaningful improvement in glycemic control, reduction in daily insulin requirement and reduction in the hypoglycemic and DKA episodes in an age group prone to acute complications.