AIMS

We aimed to evaluate real-world glycaemic outcomes of a tubeless hybrid closed-loop (HCL) insulin delivery system in type 1 diabetes (T1D), exploring the influence of ethnicity and socioeconomic status from a publicly funded system with universal access.

MATERIALS AND METHODS

This was a retrospective observational study in adults with T1D initiating HCL (Omnipod® 5) at a large publicly funded multi-site diabetes service. Baseline glycaemic metrics were compared with 12-week post-initiation data. Clinical data and social determinants of health, such as ethnicity and socioeconomic deprivation indices, were analysed for subgroup differences.

RESULTS

One hundred and sixty adults with T1D were included (26.9% non-White; 48.8% in the two most deprived IMD quintiles). Mean time in range (%TIR; 3.9-10 mmol/L) improved from 52.7 ± 16% to 67.9 ± 12.7% (p < 0.001). Improvements were consistent across ethnic groups (mean % TIR +14.8% [95% CI: (12.6%, 17.3%)] and + 16.1% [95% CI: 12.4%, 19.7%] in White and non-White individuals, respectively, p = 0.488) and socioeconomic strata (mean % TIR + 15.9% [95% CI: 13.3%, 18.6%] and + 14.2% [95% CI: 11.2%, 17.1%] in those from lower and higher socioeconomic groups, respectively, p = 0.290). Those with poorer baseline glycaemia experienced greater improvements.

CONCLUSIONS

Early real-world use of a tubeless HCL system demonstrated significant and equal glycaemic improvements in diverse ethnic and socioeconomic groups. Promoting universal access to HCL technologies in T1D is therefore essential to ensure existing disparities in glycaemic outcomes are minimised.