Endocrine Abstracts

JOINT260

Background: Hybrid closed-loop (HCL) systems combine continuous glucose monitoring (CGM) with insulin pumps to automate insulin delivery through specific algorithms and user input. The recent updated UK NICE Technology Appraisal (TA943) on HCLs for T1D was published in December 2023. It advocates for widespread National Health Service (NHS) adoption and access to these systems for all children with T1D. This represents a significant and positive move towards universal health accessibility to advanced diabetes technologies. The Omnipod 5 system (OP5) by Insulet Corp. is a tubeless automated insulin delivery system, and as of June 2023, was the latest HCL system to be introduced in the United Kingdom (UK). This real-world study aimed to evaluate the effectiveness of the Omnipod5 HCL system on HbA1c, time-in-range (TIR), hypoglycaemia frequency, and sensor glucose variability over 3 and 6 months in children and young people with type 1 diabetes at two NHS-funded paediatric diabetes centres in the North West of England.

Methods: Children under 18 years of age in two teaching hospital-based diabetes centres were started on Omnipod5 between August 2023 and January 2024. Sensor glucose metrics and HbA1c were collected within 3 months prior to Omnipod5 initiation and compared at 3 and 6 months post-initiation. Metrics included %TIR (sensor glucose 3. 9–10. 0 mmol/l), time above range (TAR) (sensor glucose >10. 0 mmol/l and >13. 9 mmol/l), and time below range (TBR) (sensor glucose <3. 9 mmol/l and <3. 0 mmol/l), with variability assessed by coefficient of variation (CV) and standard deviation (SD).

Results: A total of 144 children were included, with 46% males and a mean age of 7. 1 years (SD 4. 3). The cohort was predominantly white (80%), with diabetes duration averaging 4. 4 years (SD 3. 9). Prior to Omnipod5, 54% used multiple daily injections, 41% a non-integrated pump, and 5% another HCL system. At 3 and 6 months post-initiation, there were significant improvements in HbA1c (from 60. 2 mmol/mol to 54. 4 mmol/mol at 3 months, and 55. 2 mmol/mol at 6 months), TIR (from 53. 3% at baseline to 67. 4% at 3 months and 68. 8% at 6 months), and reductions in TAR and CV.

Conclusions: These findings highlight the Omnipod5 system’s safety and effectiveness in improving glycaemic control for CYP with T1D in a real-world NHS setting. Further research is needed to explore the long-term benefits and cost-effectiveness of this tubeless HCL system in routine clinical care.