Technological implementation and evolution of metabolic control in pediatric T1D patients: [ldquo]real life experience[rdquo]

Najera Nancy Portillo; Arlegui Amaia Sanchez; Zamalloa Claudia Cifuentes; Bolado Gema Grau; Desojo Amaya Vela; Itxaso Rica

doi:10.1530/endoabs.110.EP377

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Endocrine Abstracts (2025) 110 EP377 | DOI: 10.1530/endoabs.110.EP377

ECEESPE2025 ePoster Presentations Diabetes and Insulin (245 abstracts)

Technological implementation and evolution of metabolic control in pediatric T1D patients: “real life experience”

Nancy Portillo Najera ^1,2 , Amaia Sanchez Arlegui ^1,2 , Claudia Cifuentes Zamalloa ^1,2 , Gema Grau Bolado ^1,2 , Amaya Vela Desojo ^1,2 & Itxaso Rica ^1,2

Author affiliations

¹Cruces University Hospital., Pediatric Endocrinology, Barakaldo, Spain; ²BioBizkaia. Health Research Institute, Pediatric Endocrinology, Barakaldo, Spain

JOINT1171

The technological advances in the treatment of pediatric patients with Type 1 Diabetes (T1D) facilitate metabolic control. The ISPAD in 2018 and the ADA in 2020, proposed reaching an HbA1c <7% as a goal. Basque Country (November 2017), the first autonomous community at Spain to approve continuous glucose monitoring (CGM) systems for pediatric T1D patients.

Objective: To know the evolution of metabolic control in T1D patients in a tertiary hospital and its possible relationship with the implementation of technologies. To compare two samples exploiting data exported in 2019 and 2023 from the SWEET registry(*) and the mean Hba1c with that published in our department prior to technological implementation (AvDiabetol.2014;30:82).

Patients and methodology: n =170 patients in 2023. Variables: age, sex, age at T1D onset, time of evolution, insulin therapy regimen, use of CGM systems, DKA at onset, HbA1c, time in range(TR) and associated comorbidity. Results were compared with another cohort controlled in 2019 (n =141) and the mean HbA1c with that previously published in 2000 (n =82), 2008 (n =76) and 2013 (n =106).

Results: 2023 cohort n =170, data in Table 1. Subgroup with AID system (n =49) are younger, younger age at onset and better HbA1c (7.04%±0.6 vs 7.4%±0.9). The subgroup with DKA at onset (n =87) has a longer time of evolution and worse metabolic control (7.47%±0.98 vs 7.12%±0.76). Comparison cohort 2023 and 2019: The proportion of CGM and AID systems use is higher in 2023, no change in the rest of the variables (Table 1).HbA1c evolution Mean HbA1c at years 2019 and 2023 is lower than reported in the 3 cohorts studied (8.2% vs 7.9% vs 7.8%; years 2000, 2008 and 2013).

Table 1. Student’s t-test for quantitative variables, chi-square for qualitative variables. Statistical significance level P<0.05.
Descriptive	2019(n =141)	2023(n =170)	p
Age at onset(years)	6.9±3.9	6.5±3.7	ns
Age at the consultation(years)	12.8±4.5	12.1±4.2	ns
Evolution time(years)	5.8±4.3	5.5±3.9	ns
HbA1c(%)	7.4±1.03	7.3±0.8	ns
Insulin dosage(UI/kg/día)	0.83±0.3	0.75±0.26	P = 0.006
Sex(% female)	44.7	45.3	ns
DKA at onset (severe)(%)	49(7.8)	51(7.6)	ns
Proportion using AID systems(%)	14	29	P = 0.002
Proportion using CGM systems(%)	77	91	P<0.001
SWEET registry (Better control in Pediatric and adolescent diabeteS: Working to crEate cEnTers of reference*)

Conclusions: The use of AID system is associated with improved metabolic control, being the DKA at onset a risk factor for not achieving it. Technological implementation is associated with an improvement in HbA1c. Metabolic control is acceptable at present, can still be optimized.