6278 A comparison of the effects of insulin pump therapy vs multiple daily injections on BMI-SDS and other outcomes in children with type 1 diabetes mellitus

Objectives The National Paediatric Diabetes Audit (NPDA) 2021/22 identified that Sheffield Children's Hospital (SCH) had a higher prevalence of overweight and obese patients, and a higher proportion of patients treated with insulin pump therapy, compared to the national average for England.1Whilst insulin pumps have been associated with better glycaemic control, reducing the risk of long-term vascular and neurological complications, a risk of weight gain should be investigated further, especially given the increasing use of insulin pump therapy as a treatment for type 1 diabetes mellitus (T1DM).2 3 We sought to determine if insulin pump therapy is associated with higher body mass index standard deviation score (BMI-SDS), compared to multiple daily injections (MDI), and if glycaemic control and total daily insulin dose was impacted by the type of insulin regimen. Methods Patients with T1DM were identified from the SCH database and newly diagnosed patients (Results Of 237 patients aged 2–17 years with T1DM, 67.5% (n=160) were identified as pump therapy users and 32.5% (n=77) were MDI users. The mean BMI-SD score of the insulin pump therapy group was higher than the MDI group (0.861 and 0.642, respectively). Patients using insulin pump therapy had a significantly lower mean HbA1c than the MDI group (53.03 and 62.08, respectively). The MDI group had a lower mean TDD compared to the insulin pump therapy group (33.72 and 41.58 units, respectively). Conclusion Results concluded the insulin pump therapy group had an average BMI-SD score higher than the MDI group. The results also identified the insulin pump therapy group had improved glycaemic control but higher average TDD than the MDI group. These results highlight that more dietary education is needed to support patients changing to pump therapy, to ensure they are not compromising their metabolic risk through weight gain for improved glycaemic control. More defined guidance around recommended carbohydrate intake may also be needed. References National Paediatric Diabetes Audit 2021–2022: Unit, Regional and National Data. Royal College of Paediatrics and Child Health; 2023. Marigliano M, Eckert AJ, Guness PK, Herbst A, Smart CE, Witsch M, et al. Association of the use of diabetes technology with HbA1c and BMI-SDS in an international cohort of children and adolescents with type 1 diabetes: The SWEET project experience 2021. National Paediatric Diabetes Audit Annual Report 2021–22: Care Processes and Outcomes. Royal College of Paediatrics and Child Health 2023.