716-P: Transition from Multiple Daily Injections (MDI) to Omnipod 5 Automated Insulin Delivery System Improves A1C in Type 1 Diabetes (T1D)

Abstract

Many of those with T1D in the US use MDI as their insulin delivery method. Hybrid closed-loop (HCL) systems such as the Omnipod 5 System may improve glycemic outcomes and reduce treatment burden, however, these systems must be accessible to current MDI users. We performed a subgroup analysis of participants transitioning directly from MDI in the pivotal study of the Omnipod 5 System. Children (6-13.9 y) and adults (14-70 y) with T1D≥6 months and A1C<10% used the HCL system for 3 months at home, after a 14-d run-in phase of MDI as their standard therapy (ST). Primary efficacy endpoints were change in A1C and percent time with sensor glucose in target range (TIR, 70-180 mg/dL) during HCL compared with MDI. Thirteen children (mean±SD, age 11±2 y, T1D duration 4±2 y, A1C 7.7±1.0%, 77% CGM users) and 23 adults (age 38±13 y, T1D duration 16±12 y, A1C 7.4±0.9%, 91% CGM users) used MDI as ST. HCL use among children and adults improved TIR by 16.7±14.0% and 12.7±12.5%, and reduced A1C by 1.0±0.8% and 0.5±0.7%, respectively, compared with MDI (all p<0.05, Table). There were no episodes of severe hypoglycemia or diabetic ketoacidosis in this subgroup. Direct transition from MDI to the Omnipod 5 System is feasible and effective in reducing A1C and improving TIR in T1D. Most participants (97%) chose to continue HCL use during an extension phase, suggesting high acceptability of the system among MDI users.View largeDownload slideView largeDownload slide DisclosureV. Shah: Advisory Panel; Self; Medscape, Sanofi, Research Support; Self; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Novo Nordisk, Sanofi, vTv Therapeutics. L. M. Laffel: Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Dexcom, Inc., Dompe, Insulogic LLC, Janssen Pharmaceuticals, Inc., Laxmi Therapeutic Devices, LifeScan, Lilly Diabetes, Medtronic, Provention Bio, Inc. G. Aleppo: Consultant; Self; Dexcom, Inc., Insulet Corporation, Research Support; Self; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Novo Nordisk. B. A. Buckingham: Advisory Panel; Self; Medtronic, Tolerion, Inc., Research Support; Self; Beta Bionics, Inc., Insulet Corporation, Medtronic, Tandem Diabetes Care. D. Desalvo: Consultant; Self; Insulet Corporation, Research Support; Self; Insulet Corporation, Speaker’s Bureau; Self; Dexcom, Inc. I. B. Hirsch: Consultant; Self; Abbott Diabetes, Bigfoot Biomedical, Inc., Research Support; Self; Insulet Corporation, Leona M. and Harry B. Helmsley Charitable Trust, Medtronic. S. A. Macleish: Advisory Panel; Self; Insulet Corporation. J. E. Pinsker: Advisory Panel; Self; Medtronic, Consultant; Self; Eli Lilly and Company, Tandem Diabetes Care, Research Support; Self; Dexcom, Inc., Insulet Corporation, Medtronic, Tandem Diabetes Care. T. T. Ly: Employee; Self; Insulet Corporation. A. B. Criego: Consultant; Self; Bigfoot Biomedical, Inc., Other Relationship; Self; Sanofi, Research Support; Self; Abbott Diabetes, Eli Lilly and Company, Insulet Corporation, Medtronic. A. L. Carlson: Board Member; Self; JDRF, Other Relationship; Self; Medtronic, Research Support; Self; Abbott Diabetes, Dexcom, Inc., Eli Lilly and Company, Novo Nordisk, Omnipod, Sanofi, UnitedHealth Group. A. Bhargava: Research Support; Self; Abbott, AbbVie Inc., Amgen Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Covance Inc., Dexcom, Inc., Eli Lilly and Company, Gan & Lee Pharmaceuticals, Gan & Lee Pharmaceuticals, Insulet Corporation, Janssen Research & Development, LLC, Madrigal Pharmaceuticals, Inc., Medtronic, Merck & Co., Inc., Mylan N. V., Novo Nordisk, Quintiles, Sanofi, Senseonics, Senseonics, Tolerion, Inc., viking. B. W. Bode: Advisory Panel; Self; Eli Lilly and Company, Consultant; Self; Bigfoot Biomedical, Inc., Companion Medical, Lexicon Pharmaceuticals, Inc., Medtronic, Novo Nordisk Inc., Zealand Pharma A/S, Research Support; Self; Abvance Therapeutics, Dexcom, Inc., Diasome Pharmaceuticals, Inc., Dompe, Eli Lilly and Company, Eyenuk, Inc., Insulet Corporation, Jaeb Center for Health Research, Medtronic, Nova Biomedical, Novo Nordisk, Provention Bio, Inc., REMD Biotherapeutics, Sanofi, Senseonics, Viacyte, Inc., vTv Therapeutics, Xeris Pharmaceuticals, Inc., Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, MannKind Corporation, Medtronic, Novo Nordisk, Sanofi, Stock/Shareholder; Self; AgaMatrix, Aseko, Inc., Glytec, LLC. S. A. Brown: Research Support; Self; Dexcom, Inc., Insulet Corporation, Roche Diabetes Care, Tandem Diabetes Care, Tolerion, Inc.FundingInsulet Corporation