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Automated Insulin Delivery Is Associated with Reduced Hospital Admissions and Costs for Acute Diabetes Complications

Mercedes J Burnside1,2, Katrina Ellis2, Timothy W Jones1,2

  • 1Children's Diabetes Centre, The Kids Research Institute Australia, The University of Western Australia, Perth, Australia.

Diabetes Technology & Therapeutics
|October 13, 2025
PubMed

Insights

Automated insulin delivery (AID) systems significantly reduce hospitalizations and healthcare costs for children with type 1 diabetes (T1D) compared to multiple daily injections (MDI). This insulin management approach offers substantial savings and improved patient outcomes.

Area of Science:

  • Pediatric Endocrinology
  • Health Economics
  • Diabetes Management Technology

Background:

  • Type 1 diabetes (T1D) management in children requires careful insulin administration to prevent acute complications.
  • Different insulin regimens, including automated insulin delivery (AID), non-AID pumps, and multiple daily injections (MDI), are used in pediatric T1D care.
  • Understanding the comparative effectiveness and cost-efficiency of these regimens is crucial for optimizing patient outcomes and resource allocation.

Purpose of the Study:

  • To evaluate the association between various insulin regimens and hospitalizations for acute diabetes complications in children with T1D.
  • To assess the healthcare costs associated with different insulin delivery methods in pediatric T1D.
  • To compare the incidence of diabetic ketoacidosis and hypoglycemia across AID, non-AID pump, and MDI users.

Main Methods:

  • Retrospective analysis of hospital admissions for acute diabetes complications in Western Australian children with T1D from January 2022 to April 2024.
  • Exclusion of admissions for newly diagnosed T1D.
  • Calculation of incidence rate ratios using generalized estimating equations, adjusted for age, diabetes duration, and socioeconomic status, with cost valuation based on Australian hospital data.

Main Results:

  • Children using AID had the lowest admission rate (1.98 per 100 patient-years) and associated costs (AUD 20,132).
  • Multiple daily injections (MDI) showed the highest admission rate (5.86 per 100 patient-years) and costs (AUD 59,574).
  • Compared to AID, MDI was associated with a 2.74-fold increased hospitalization rate (P=0.0036), while non-AID pumps showed a 1.62-fold increase (P=0.150).

Conclusions:

  • Automated insulin delivery (AID) is linked to significantly lower hospitalization rates for acute diabetes complications in children with T1D.
  • AID use demonstrates substantial cost savings, approximately AUD 40,000 per 100 patient-years, compared to MDI.
  • These findings support the adoption of AID systems for improved clinical outcomes and economic benefits in pediatric T1D management.

Keywords:
automated insulin deliveryhospitalization costspediatricstreatment regimentype 1 diabetes

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