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Automated insulin delivery relates to lower HbA1c values in people with type 1 diabetes (PwT1D) participating in clinical trials, but real-world evidence is lacking. This observational crossover study used medical record data from PwT1D newly diagnosed between 2019-2023 from 32 centers in the T1D Exchange Quality Improvement Collaborative. We used real-world Electronic medical record (EMR) data to examine HbA1c levels among people with type 1 diabetes (PwT1D) classified as MDI users after T1D diagnosis and changed to AID during follow-up, versus people who changed to non-AID pump therapy. We compared HbA1c levels when initially using MDI to HbA1c levels after starting insulin pump therapy with and without AID. There were 1,578 PwT1D who changed from MDI to AID after median (IQR) duration of 2.1 (2.3) years and 2,825 who changed to non-AID pump therapy after 0.8 (1.2) years. Among PwT1D who changed to AID, median (IQR) HbA1c decreased from 7.7 (1.7) to 7.4 (1.7) and HbA1c decreased from 8.0 (1.9) to 7.9 (1.9) among those changing to non-AID pump therapy. Odd Ratio (95% CI) of having an HbA1c 7.0% was 1.60 (1.34, 1.92) when changing to AID compared to non-AID pump therapy after adjusting for confounders. We saw a greater decline in HbA1c levels and severe hypoglycemic episodes observed in AID users vs those using non-AID pump therapy. Disclosure S. Rompicherla: None. K. Miller: Consultant; Dexcom, Inc. Research Support; Dexcom, Inc. L.C. Chao: None. H.K. Akturk: Consultant; Medtronic. Research Support; Medtronic. Consultant; Dexcom, Inc. Research Support; MannKind Corporation, Tandem Diabetes Care, Inc. Consultant; Tandem Diabetes Care, Inc. G.T. Alonso: Advisory Panel; MannKind Corporation. G.M. Davis: Research Support; Insulet Corporation. Consultant; Medscape. D. DeSalvo: Advisory Panel; Insulet Corporation. Consultant; Dexcom, Inc. R.S. Weinstock: Research Support; Eli Lilly and Company, Tandem Diabetes Care, Inc., Diasome, Amgen Inc., MannKind Corporation, Insulet Corporation, Novo Nordisk. Other Relationship; Dexcom, Inc. S. Hsieh: None. M.K. Kamboj: None. R. Rapaport: None. O. Ebekozien: Advisory Panel; Sanofi, Medtronic. Research Support; Vertex Pharmaceuticals Incorporated. Speaker's Bureau; Vertex Pharmaceuticals Incorporated. Research Support; Medtronic, Lilly Diabetes, Abbott, Dexcom, Inc. Funding Helmsley Charitable Trust
Rompicherla et al. (Fri,) studied this question.