The Type of Patient Training Does Not Impact Outcomes in the First 90 Days of Automated Insulin Delivery Use.

Abstract

Youth starting Omnipod 5 (OP5) can onboard with a diabetes educator or self-start with support from online, industry-provided educational modules. We compared glycemic control and pump interaction by training type among youth initiating OP5. This retrospective review included 297 youth with type 1 diabetes (T1D) aged <22 years initiating OP5. We analyzed baseline CGM data and pump and CGM data from the first 90 days of OP5 use. Multilevel mixed-effects regression assessed for changes in time in range (TIR) from baseline to 90 days by training type. Of youth initiating OP5 42.4% trained with a diabetes educator and 57.6% self-started. At baseline self-starters had a longer T1D duration (5.0 (2.6,7.9) vs 2.5 (1.3,5.5) years, p=0.001), more time <54 mg/dL (0.3% (0.1,1) vs 0.15% (0,1), p=0.01), and a higher coefficient of variation (40.2% (37,44.4) vs 38.7% (34.4,42.4), p=0.004). After 90 days of OP5 use, groups did not differ in time in automated mode or boluses per day. In a longitudinal model, after adjusting for baseline TIR and T1D duration, 90-day TIR was 10.5%-points higher (CI 9.2-11.8, p<0.0001), positively associated with baseline TIR (β=0.82, CI 0.78-0.85, p<0.0001), and 1.1%-point greater among self-starters (CI 0.06-2.2; p=0.04). After 90 days of OP5 use glycemic control and pump interactions were minimally different between youth who self-started and those who trained with a diabetes educator. For youth at a tertiary care center previously using an Omnipod system, online educational modules offered by industry provides sufficient training for use.