Automated insulin delivery (AID) systems are increasingly used in the management of type 1 diabetes mellitus (T1DM), but large-scale real-world data in pediatric populations remain limited. An observational comparative analysis published in Diabetes Research and Clinical Practice evaluated glycemic outcomes before and after AID initiation in children and adolescents with T1DM using the international SWEET registry.

The study included 2170 participants aged 18 years or younger from 53 centers across 29 countries. Glycemic outcomes were compared across two periods, defined as 12 months before and after AID initiation. Primary endpoints included glycated hemoglobin (HbA1c), mean sensor glucose, and time spent across predefined glycemic ranges.

Following AID initiation, time in range (70-180 mg/dL) and time in a tighter range (70–140 mg/dL) increased, while mean sensor glucose and glycemic variability decreased. Time below range (<70 mg/dL) was reduced, indicating lower exposure to hypoglycemia. HbA1c improved, with no significant change observed in total daily insulin dose.

These findings indicate that AID therapy improves multiple glycemic parameters and reduces hypoglycemia in pediatric T1DM across diverse real-world settings. The results support the effectiveness of AID systems in routine clinical care for children and adolescents.