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Pilot Study of Early Adoption of Automated Insulin Delivery in Underresourced Youth

Kevin Yen1, Sonali Belapurkar1, Cassidy Puckett2

  • 1Division of Endocrinology, Department of Pediatrics, University of California San Francisco, San Francisco, California, USA.

Journal of Diabetes Research
|November 17, 2025
PubMed

Insights

Early automated insulin delivery (AID) is feasible and acceptable for children with Type 1 diabetes from underresourced backgrounds. This approach can improve time in range and technology adoption in this population.

Area of Science:

  • Pediatric Endocrinology
  • Diabetes Technology
  • Health Disparities

Background:

  • Children with Type 1 diabetes (T1D) from underresourced backgrounds often face disparities in outcomes and technology use.
  • The feasibility of early automated insulin delivery (AID) initiation in this population is uncertain.
  • This pilot study addresses the feasibility and acceptability of early AID system access for publicly insured youth with T1D.

Purpose of the Study:

  • To assess the feasibility and acceptability of providing access to the Tandem Control-IQ AID system.
  • To evaluate early AID initiation for children with public insurance soon after T1D diagnosis.
  • To explore user experience and safety of AID in a pediatric T1D cohort.

Main Methods:

  • A pilot study randomized publicly insured children (6-21 years) within 3 months of T1D diagnosis to AID or usual care for 6 months.
  • Continuous glucose monitoring data were collected at baseline, 3, and 6 months.
  • Caregiver and youth surveys, along with focus group interviews, assessed safety and user experience.

Main Results:

  • Nineteen youth enrolled (13 AID, 6 usual care); 89% were from underrepresented racial/ethnic groups.
  • A higher proportion of the AID group achieved >70% time in range compared to the control group at 3 and 6 months.
  • High satisfaction reported by caregivers (100%) and youth (69%) in the AID group, with 85% continuing AID use post-study.

Conclusions:

  • Early AID initiation is feasible and acceptable for recently diagnosed T1D youth from underresourced populations.
  • AID may improve glycemic outcomes and technology adoption in historically underserved T1D populations.
  • Diabetes clinicians should consider providing tailored support for early AID initiation and continued use in these families.
Abstract

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