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Factors Associated With Time to Automated Insulin Delivery System Initiation in Youth With Type 1 Diabetes
Neha Parimi1, Charles Wu1, Jaydan Ziglar1
1Department of Pediatrics, Division of Pediatric Endocrinology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Journal of Diabetes Science and Technology
|March 21, 2026
Summary
Initiating automated insulin delivery (AID) systems takes time, with longer diabetes duration and area deprivation delaying the process. Early discussions and social support can improve AID initiation efficiency.
Area of Science:
- Endocrinology
- Diabetes Technology
- Pediatric Endocrinology
Background:
- Automated insulin delivery (AID) systems represent a significant advancement in type 1 diabetes management.
- The initiation of AID involves a complex, multi-step process from decision to therapy start.
Purpose of the Study:
- To assess the time to automated insulin delivery (TT-AID) initiation in youth with type 1 diabetes.
- To identify factors influencing the duration of the AID initiation process.
Main Methods:
- Retrospective study of 270 insulin pump-naive youth with type 1 diabetes initiating AID.
- Data collected from electronic medical records and device portals.
- Time-to-event analysis used to determine TT-AID and influencing factors.
Main Results:
- Median TT-AID was 43.5 days, with the longest interval between prescription and training (37.5 days).
- Longer diabetes duration (>1 year) and higher area deprivation index were associated with significantly increased TT-AID.
- No significant differences in TT-AID were observed based on insurance or AID system type.
Conclusions:
- The AID initiation process can be lengthy, with delays influenced by diabetes duration and socioeconomic factors (area deprivation).
- Interventions focusing on early AID discussions and enhanced social support are recommended to streamline AID initiation.
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