What question did this study set out to answer?

This study aims to evaluate the effects of transitioning from multiple daily injections to insulin pump therapy in children and adolescents with type 1 diabetes mellitus.

June 19, 2026Open Access

The Impact of Insulin Pump Therapy on Glycemic Regulation in Children and Adolescents with Type 1 Diabetes Mellitus—Preliminary Data from a Single Tertiary Pediatric Center

Key Points

This study aims to evaluate the effects of transitioning from multiple daily injections to insulin pump therapy in children and adolescents with type 1 diabetes mellitus.
Evaluated 50 pediatric patients with type 1 diabetes mellitus over 6 months.
Measured glycemic control metrics pre-transition and at three- and six-month intervals post-transition to either automated insulin delivery or non-automated systems.
Assessed parameters included HbA1c, TIR, TAR, TBR, GMI, and CV.
Significant increase in time in range (TIR) from 70.9% at 3 months to 73.2% at 6 months (p=0.0038).
Time above range (TAR) decreased significantly to 26.5% at 3 months and 24.3% at 6 months (p=0.033).
In the automated insulin delivery group, TIR showed a marked increase (p=0.0001) with reductions in TAR (p=0.0009) and GMI (p=0.03).

Abstract

Background/Objectives: Advanced technologies in type 1 diabetes mellitus (T1DM) management have reshaped the strategies used to achieve optimal glucose control. Continuous subcutaneous insulin infusion (CSII) and automated insulin delivery (AID) systems are effective alternatives to multiple daily injections (MDI). This study aims to evaluate glycemic regulation in children and adolescents transitioning from MDI to insulin pumps and to raise awareness among patients and their families regarding the benefits of these systems. Methods: 50 pediatric patients with T1DM (24 males, 26 females; mean age 10.76 ± 3.2 years) were evaluated. Cycle 1 established MDI metrics 3 months pre-transition. In cycle 2, patients transitioned either to an AID system (Medtronic MiniMed 780G, (Northridge, CA, USA), 78%), or a non-automated system (Omnipod DASH, 22%). Data were assessed at 3 and 6 months post-initiation. Parameters assessed were glycosylated hemoglobin (HbA1c), time in range (TIR), time above range (TAR), time below range (TBR), glucose management indicator (GMI) and coefficient of variation (CV). Results: The cohort exhibited a statistically significant increase in TIR (p = 0.0038) with mean values of 70.9% at 3 months and 73.2% at 6 months. TAR significantly reduced (p = 0.033) to 26.5% and 24.3% at 3 and 6 months, respectively. Sub-analysis in the AID group revealed a marked increase in TIR (p = 0.0001) alongside significant reductions in TAR (p = 0.0009) and GMI (p = 0.03). Conclusions: Transitioning from MDI to insulin pump therapy, particularly AID systems, leads to modest but significant improvements in specific sensor metrics (TIR, TAR) in real-world clinical practice. The consistency of these results across age groups indicates that AID systems can successfully overcome pediatric and adolescent diabetes management challenges.

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