Objective: Glycemic outcomes in youth with type 1 diabetes (T1D) in the United States using the two most common automated insulin delivery (AID) systems, Insulet Omnipod 5 (OP5) and Tandem Control IQ (CIQ), have not been compared. We performed the first head-to-head analysis of changes in glycemic metrics among youth initiating AID.
Methods: This single center, retrospective study included youth <21 years with T1D, who started OP5 or CIQ between 1/2020 and 12/2023, and had ≥70% CGM active time. 14-day baseline and 90-day CGM and AID data were obtained. A multiple linear regression model assessed for changes in 90-day time in range (TIR) according to AID system, adjusting for covariates. Sub-analyses were conducted according to baseline TIR categories.
Results: Among the 428 youth included, there were 214 (50%) in each AID group. OP5 users had a shorter T1D duration (1.6 vs 5.5 years, p<0.001) and were more likely to have transitioned from multiple daily injections (76.1% vs 20.1%, p<0.001). Baseline TIR was similar between groups (OP5 51.6% vs CIQ 53.1%, p=0.70). 90-day TIR increased in both groups (p<0.001), rising by 11.8%-points (95% CI[10.4,13.3]) in OP5 users and 9.8%-points (95% CI[8.3,11.2]) in CIQ users, without any significant between group differences (p=0.08). There were no between group differences in 90-day TIR according to categorical baseline TIR.
Conclusions: There are no clinically significant differences in 90-day TIR among youth with T1D initiating the two most commonly used AID systems. Patient preference and shared decision making should continue to guide the selection of AID systems.
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