The use of pumps with Automated Insulin Delivery (HCL/AHCL) improves the Sleep Quality of Children and Adolescents with Type 1 Diabetes and of their parents/caregivers

Marco Marigliano; Claudia Piona; Valentina Mancioppi; Elisa Morotti; Elena Fornari; Francesca Olivieri; Anita Morandi; Claudio Maffeis

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ESPE Abstracts (2024) 98 P1-228

ESPE2024 Poster Category 1 Diabetes and Insulin 4 (8 abstracts)

The use of pumps with Automated Insulin Delivery (HCL/AHCL) improves the Sleep Quality of Children and Adolescents with Type 1 Diabetes and of their parents/caregivers.

Marco Marigliano , Claudia Piona , Valentina Mancioppi , Elisa Morotti , Elena Fornari , Francesca Olivieri , Anita Morandi & Claudio Maffeis

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Section of Pediatric Diabetes and Metabolism, Department of Surgery, Dentistry, Pediatrics, and Gynecology, University of Verona, Verona, Italy

Background and Objective: Type 1 Diabetes (T1D) is one of the most frequent endocrine-metabolic diseases in children and youth. Several studies assessed Sleep Quality (SQ) in Children with Diabetes (CwD), yielding conflicting results. This study aims to test the hypothesis that the use of glucose sensors and insulin pumps in T1D is associated with better QOL and SQ in a group of CwD and their parents/caregivers

Subjects and Methods: 122 CwD (age 6-15) treated with Multiple Daily Injections (MDI), Sensor Augmented Insulin Pump (SAP), and Automated Insulin Delivery systems (HCL/AHCL) were enrolled. The Epworth Sleepiness Scale (ESS), Hypoglycaemia Fear Survey for Parents II (HFS-P II), Sleep Disturbance Scale for Children (SDSC), and Pediatric Quality of Life Inventory 3.2 (PedsQL 3.2) questionnaires were administered. Demographic, clinical, anthropometric, and insulin therapy-related parameters were collected. Glycemic control metrics downloaded from the glucose monitoring sensor were also analyzed.

Results: More than 50% of CwD (62%) and their parents/caregivers (52%) reported poor SQ. CwD treated with HCL/AHCL had better glucose control [%Time in Range (%TIR)] vs MDI and SAP (62.7% vs 55.8 and 56.5%, P <0.05). CwD with higher %TIR had a direct correlation with higher QOL (PEDsQL r:0.368; P < 0.01); higher PEDsQL scores were significantly correlated with better scores at the SQ questionnaires [ESS (r:-0,281; P <0.01), HFS-P II (r:0.420; P <0.001) and SDSC (r:-0.426; P <0.001)].

Conclusion: The use of Automated Insulin Delivery systems (HCL/AHCL) is associated with better glycemic control, higher QOL, and better scores on SQ questionnaires.