Early Automated Insulin Delivery Improves Outcomes in Type 1 Diabetes: Study

A study published in the journal of Diabetes Technology & Therapeutics⁠ found that children with type 1 diabetes who began using automated insulin delivery (AID) systems within six months of diagnosis achieved better long-term glycemic control and experienced fewer episodes of diabetic ketoacidosis over a 2-year period when compared to nonusers. Researchers suggest that early adoption of these systems may help blunt the typical rise in A1C levels seen after the honeymoon phase of diabetes, according to Dr. Elizabeth Mann.

Automated insulin delivery systems combine continuous glucose monitoring with insulin pumps that automatically adjust insulin delivery based on real-time blood sugar readings. The systems are considered as a major advancement in diabetes care, especially for children and adolescents who often face significant challenges maintaining stable glucose levels.

This retrospective cohort study analyzed data from 9,856 young people diagnosed with type 1 diabetes between 2020 and 2022 across 27 diabetes centers in the US. This study examined how the timing of AID initiation influenced hemoglobin A1c (HbA1c) levels, diabetic ketoacidosis (DKA), and severe hypoglycemia during the first two years after diagnosis.

These participants were divided into four groups based on when they began using AID technology: within six months of diagnosis, between six and 12 months, between 13 and 24 months, or no AID use at all. The children who began using AID systems within the first six months after diagnosis had a median HbA1c level of 7.1% at 24 months, which was considered close to recommended treatment targets.

By comparison, participants who never used AID technology had substantially poorer glucose control, with median HbA1c levels reaching 9.8% after two years. The timing of AID initiation remained an independent predictor of HbA1c outcomes even after adjusting for other clinical and demographic variables, which suggested that earlier adoption itself contributes meaningfully to improved diabetes management.

DKA occurred approximately three times more often among children who did not use AID systems when compared to those who started early. These findings reinforce growing evidence that rapid integration of diabetes technology shortly after diagnosis may improve both short-term safety and long-term metabolic control.

The early period after type 1 diabetes diagnosis can be especially challenging for families as they learn insulin dosing, carbohydrate counting, glucose monitoring, and emergency management. Overall, the findings emphasized that timely initiation of AID systems may depend on insurance coverage, healthcare resources, socioeconomic factors, and disparities in technology availability.

Source:

Mann, E. A., Prahalad, P., Wolf, R., Mathioudakis, N., Rioles, N., Rompicherla, S., Odugbesan, O., Thapa, S., Vigersky, R., & Ebekozien, O. (2026). Early initiation of automated insulin delivery at type 1 diabetes diagnosis in children and adolescents is associated with improved outcomes. Diabetes Technology & Therapeutics, 15209156261441491, 15209156261441491. https://doi.org/10.1177/15209156261441491