This retrospective cohort study evaluates the impact of timing of automated insulin delivery (AID) initiation on glycemic outcomes in youth with type 1 diabetes.
Methods:
Data from 9856 children and adolescents diagnosed with type 1 diabetes between 2020 and 2022 across 27 U.S. centers were analyzed. Participants were grouped by AID initiation timing in months: <6, 6–12, 13–24, or no AID use. Hemoglobin A1c (HbA1c) trajectories, diabetes-associated ketoacidosis (DKA), and severe hypoglycemia rates were assessed over 24 months after T1D diagnosis.
Results:
Earlier AID initiation was associated with lower HbA1c at 24 months (median 7.1% in the <6-month group vs. 9.8% in non-users, P < 0.001). DKA rates were threefold higher in non-AID users. Adjusted models confirmed the timing of AID initiation independently predicted HbA1c outcomes.
Conclusions:
Early AID initiation is associated with improved glycemic control and reduced DKA risk, underscoring the importance of timely and equitable access to AID systems.
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