The research, led by Maaria Kiilavuori and colleagues from the Children’s Hospital, Pediatric Research Center, Helsinki University Hospital, and the University of Helsinki, Finland, followed young patients using AID over two years to evaluate its long-term benefits.
The study involved 79 participants aged 7 to 16 years with suboptimal glycemic control, defined as HbA1c levels above 7.0%. Researchers tracked several parameters—including time in range (TIR; 70–180 mg/dL), time in tight range (TITR), HbA1c, mean sensor glucose (SG) values, time below range (TBR), and glucose variability—at baseline, 3, 12, and 24 months after initiating AID therapy.
The following were the key findings of the study:
- Within the first three months of AID use, the average time in range (TIR) increased by 18.1%.
- Time in tight range (TITR) improved by 11.7% during the same period.
- HbA1c levels dropped by approximately 0.8%.
- Mean sensor glucose levels decreased by 1.8 mmol/L.
- These improvements were sustained at both 12 and 24 months of follow-up.
- Among younger children aged 2–6 years, the proportion of time in the target glucose range rose from 56.8% to 66.6% over one year.
- Mean HbA1c levels decreased from 7.6% to 7.2%.
- Parents reported a reduced burden of diabetes management, as reflected in HAPPI-D questionnaire scores.
- No episodes of severe hypoglycemia requiring hospitalization were recorded.
- Only one case of diabetic ketoacidosis occurred during the study period.
According to the researchers, these results emphasize the effectiveness and safety of AID systems such as MiniMed 780G in real-world pediatric settings. Even among children who initially failed to meet glycemic targets, the technology enabled better glucose regulation and fewer short-term complications.
While the findings are promising, the investigators noted certain limitations. The study’s retrospective design and incomplete data collection—particularly for HbA1c readings at 3 and 12 months—were largely due to remote visits during the COVID-19 pandemic. Additionally, the study did not assess quality-of-life outcomes, which could offer a more comprehensive picture of patient benefit.
Despite these limitations, the researchers concluded that automated insulin delivery offers a valuable therapeutic option for children and adolescents with type 1 diabetes who struggle to achieve target glucose levels through standard therapy. The sustained improvement over two years suggests that AID systems could play a key role in reducing long-term diabetes-related complications and easing the burden of care for young patients and their families.
Reference:
Kiilavuori M, Varimo T, Tuomaala AK, Pulkkinen MA. Children and adolescent with suboptimal control of type 1 diabetes improve during the first 2 years on automated insulin delivery system. Diabetes Obes Metab. 2025 Jan;27(1):134-142. doi: 10.1111/dom.15992. Epub 2024 Sep 30. PMID: 39344828; PMCID: PMC11618217.
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