1898-P: Real-World Glycemic Outcomes in Early-Onset Type 2 Diabetes (T2D) with the Omnipod 5 Automated Insulin Delivery (AID) System

Introduction and Objective: T2D diagnosis before age 40y is an aggressive subgroup characterized by accelerated diabetes-related complications, increased vascular disease risk, and excess mortality. While AID improves glycemia in those with T2D, real-world data are limited, particularly among those diagnosed younger. This analysis examined real-world outcomes of Omnipod 5 use in people with early-onset T2D. Methods: A retrospective analysis of CGM and insulin data from US Omnipod 5 users with T2D aged 18-40y with sufficient CGM data (≥90 days of data, ≥75% of days with ≥220 readings) was conducted. Outcomes over the duration of device use were evaluated overall and stratified by self-reported baseline A1C. Results: A total of 2,876 users (median age 34y) spent a median 383 days on device with 92% of time in Automated Mode. Of these, 175 users had optimal system use (Target Glucose: 110 mg/dL; correction factor*total daily insulin: ≤1500; Insulin:carb ratio*total daily insulin: ≤350; Automated Mode: ≥90%; Boluses/day: ≥3), achieving median TIR of 83% with 0.6% time <70mg/dL. In those with baseline A1C (n=887) with any system settings, glucose management indicator by baseline A1C is shown in the Figure. Conclusion: These real-world data support that AID improves glycemia in those with early-onset T2D not meeting clinical targets and may alter the trajectory of diabetes-related complications in this high-risk group. Disclosure M. Van Name: Consultant; Ended; Novo Nordisk. Research Support; Current; Novo Nordisk. Consultant; Ended; Soleno Therapeutics, Inc., MannKind Corporation. Research Support; Ended; MannKind Corporation, Provention Bio, Inc. Research Support; Current; Lilly, Sanofi. J. Boyd: Employee; Current; Insulet Corporation. Stock/Shareholder; Current; Insulet Corporation, Dexcom, Inc., Abbott, Senseonics. K. Miller: Employee; Current; Insulet Corporation. L. Huyett: Employee; Current; Insulet Corporation. Stock/Shareholder; Current; Insulet Corporation. D. Do: Employee; Current; Insulet Corporation. T.T. Ly: Employee; Current; Insulet Corporation. Stock/Shareholder; Current; Insulet Corporation. Funding This study was funded by Insulet Corporation.