medwireNews: Children and adults with type 1 diabetes achieve significant reductions in glycated hemoglobin (HbA1c) and hypoglycemic events during their first 90 days of using the Omnipod DASH insulin pump system, show real-world data.
The study encompassed 4738 Omnipod DASH users (1397 <18 years) with baseline and follow-up HbA1c data available, which could be either drawn from medical records or self-reported. Their average age was 10.2 years for the under 18s and 43.8 years for the adults.
The majority of users (61% of adults and 79% of the children) had switched from multiple daily injections, at which time the average HbA1c was 8.5% (69 mmol/mol) and 8.6% (70 mmol/mol) in the adults and children, respectively.
After 90 days of use, this had fallen to a respective 7.6% (60 mmol/mol) and 7.7% (61 mmol/mol), with significant decreases seen for all age groups except infants younger than 2 years, who experienced a nonsignificant reduction, from 9.6% (81 mmol/mol) to 8.6% (70 mmol/mol).
For both adults and children, the average reduction in HbA1c was larger in people who had switched from multiple daily injections than those who had switched from a different insulin pump, but the latter group still had a significant decrease, of 0.4–0.6%.
And for both age groups, the greatest gains were observed in those with the highest HbA1c at baseline; adults and children with starting levels of 10% (86 mmol/mol) or higher achieved average reductions of 2.9% and 3.5%, respectively.
In adults and adolescents, these glycemic improvements occurred despite a significant average reduction in the amount of insulin used, which decreased from an average total daily dose of 62.3 to 49.8 U/day and of 52.1 to 46.9 U/day, respectively. In adults the largest dose reductions again occurred in the group with the highest HbA1c at baseline. In younger children there was either a slight increase or no change in insulin dose.
The number of hypoglycemic events also decreased significantly in both adults and children, and in all age categories except the under 2s. The number of episodes per week fell from an average of 2.9 to 1.3 in adults and from 2.8 to 1.5 in children.
In contrast to the HbA1c and insulin dose changes, the highest baseline rate of hypoglycemia was observed in adults and children with low HbA1c, and these people experienced the largest reductions in hypoglycemia after starting on the Omnipod DASH system.
Speaking at the virtual 57th EASD Annual Meeting, Grazia Aleppo (Northwestern University, Chicago, Illinois, USA) reminded delegates that the Omnipod is currently the only tubeless insulin pump available, and that users appreciate being able to locate the device anywhere that they would administer an injection.
She concluded: “These patient outcomes really provide evidence that the use of the Omnipod DASH was associated with reductions in A1c but also hypoglycemic events after 90 days of use for all the population of children, adolescents, and adults with type 1 diabetes.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group