Endocrine Abstracts

Introduction: Hybrid closed loop pumps (HCL) incorporate insulin pumps (IP) with continuous glucose monitoring (CGM). We reviewed the glycaemic control of patients followed up at Evelina with Type 1 Diabetes(T1D) on HCL pumps between January 2021 and December 2024.

Method: As per standard care, patients were reviewed in clinic every 3 months. We collected HbA1c and Time in range data before starting HCL and at 3months, 6months and 1 year after initiating on HCL. We also reviewed the ethnicity distribution and deprivation index among HCL users. We compared the present data with our 2023-2024 National Paediatric Diabetes Audit (NPDA) data.

Results: There were 88 patients on HCL, of which 46(52.27%) were males. Median age was 12.29 years (range 2.08- 19.38). Before starting HCL, 35 were on standard insulin pumps (39.77%) and 53 (60.22%) were on basal bolus insulin regimen. Median duration of HCL use was 1.45 years. Mean HbA1c ( mmol/mol) improved significantly from 69.77 ± 18.5 before HCL to 55.86 ± 6.49 after one year (P 0.0008). TIR (%) also increased significantly, from 46.49 ± 18.19 to 61.55 ± 8.71 after one year (P 0.0005). The proportion of patients using HCL increased from 37% (2023-2024 NPDA) to 79.3%. Black African patients made up the largest ethnic group (23.2%) in our diabetes population, with 22.8% using HCL, when compared to 9.9% in the previous year. Among patients in the lower deprivation deciles (2^nd &3^rd), 83.3% and 75% were using HCL compared to 40% and 44.3%. (2023-2024 NPDA)

Conclusion: There has been a significant improvement in glycaemic control since switching to Hybrid close loop system- both in terms of HbA1c and Time in range. Additionally, proactive use of HCL has improved equity of uptake both in terms of ethnicity and deprivation index.