1549-P: Glycemic Outcomes in Young Women with Type 1 Diabetes Using Automated Insulin Delivery: Impact of Disordered Eating Behaviors

Introduction and Objective: Disordered eating behaviors (DEB) are common in young women with type 1 diabetes (T1D) and are associated with suboptimal glycemic outcomes. The use of automated insulin delivery systems (AID) has shown to improve glycemia in individuals with T1D. However, the impact of DEBs on glycemic outcomes in AID users is unknown. Methods: Baseline data of young women (18-35 years old) including demographics, HbA1c, continuous glucose monitoring (CGM) metrics, total daily use of insulin (TDD), and Diabetes Eating Problem Scale-Revised (DEPS-R) questionnaire were collected. A DEPS-R score ≥20 indicates an increased risk of DEB. CGM data were analyzed for TIR (time in range 70-180 mg/dL), time above range (TAR 180 mg/dL), glucose management indicator (GMI%), and glycemic variability (CV%) Baseline measures were compared between participants with and without increased risk of DEB. Results: Data of 52 young women (age 25±4 years, BMI 27.6±6 Kg/m2, duration of diabetes 13±6 years; A1c 6.8±0.6%) on AID systems were evaluated. When divided by DEPS-R score (20 or ≥20), participants with an increased risk of DEB (n=18) had a higher BMI (30.5±5 vs 26.3±5.4 kg/m2; p=0.04), greater HbA1c (7.2±0.8 vs 6.5±0.7%; p=0.004), and higher TDD (61±24 vs 45±22 v; p=0.002). Additionally, CGM metrics showed that the participants with DEPS-R score ≥20 had a lower TIR (57.7±14 vs 71±15%; p=0.03), higher TAR (28 vs 42%; p=0.003), and higher GMI (7.6 vs 7.05%; p= 0.01). The coefficient of variation (CV%) did not differ between participants with and without increased risk of DEB. Conclusion: In our cohort of young women with T1D using AID systems, less optimal glycemic outcomes are seen in those people at higher risk for DEB, suggesting that AID systems do not fully mitigate behavioral barriers to glycemic control. Routine screening for DEB and targeted psychosocial support should be considered in clinical practice. Disclosure E. Toschi: Consultant; Current; Vertex Pharmaceuticals Incorporated. Advisory Panel; Current; Vertex Pharmaceuticals Incorporated. H. Brabant: None. N. Patience: Advisory Panel; Current; Amylyx. M. Savory: None. L. Wisting: None. E. Stice: None. M. de Wit: Speaker's Bureau; Ended; Sanofi. Funding This study is funded by BreakthroughT1D (4-SRA-2022-1227-M-B)