The Impact of Insulin Pump Therapy on Glycemic Regulation in Children and Adolescents with Type 1 Diabetes Mellitus

Background/Objectives: Advanced technologies in type 1 diabetes mellitus (T1DM) management have reshaped the strategies used to achieve optimal glucose control. Continuous Subcutaneous Insulin Infusion (CSII) and Automated Insulin Delivery (AID) systems are effective alternatives to multiple daily injections (MDI). This study aims to evaluate glycemic regulation in children and adolescents transitioning from MDI to in-sulin pumps and to raise awareness among patients and their families regarding the benefits of these systems. Methods: 50 pediatric patients with T1DM (24 males, 26 fe-males; mean age 10.76 ± 3.2 years) were evaluated. Cycle 1 established MDI metrics 3 months pre-transition. In cycle 2, patients transitioned either to an AID system (Medtronic MiniMed 780G, 78%), or a non-automated system (Omnipod DASH, 22%). Data were assessed at 3- and 6-months post-initiation. Parameters assessed were: Glycosylated hemoglobin (HbA1c), Time In Range (TIR), Time Above Range (TAR), Time Below Range (TBR), Glucose Management Indicator (GMI), Coefficient of Variation (CV). Results: The cohort exhibited a statistically significant increase in TIR (p=0.0038) with mean values of 70.9% at 3 months and 70.8% at 6 months. TAR significantly reduced (p=0.033) to 26.5% and 24.3% at 3 and 6 months, respectively. Sub-analysis in the AID group, revealed a marked increase in TIR (p=0.0001) alongside significant reductions in TAR (P=0.0009) and GMI (p=0.03). Conclusion: Transitioning from MDI to insulin pump therapy, particularly AID systems, is transforming the clinical landscape of T1DM management. The con-sistency of these results across age groups indicates that AID systems can successfully overcome pediatric and adolescent diabetes management challenges.