Daily Carbohydrate Entries and Glycemic Outcomes Following Automated Insulin Delivery System Initiation in Youth With Type 1 Diabetes: A Real-World Multinational Longitudinal Study

OBJECTIVE To assess the association between daily carbohydrate (CHO) entries and glycemic outcomes in youth with type 1 diabetes after automated insulin delivery (AID) initiation in real-life settings. RESEARCH DESIGN AND METHODS In this longitudinal, multinational observational study, 347 young individuals (7–21 years old) with type 1 diabetes for >1 year were followed for >6 months after AID initiation. Clinical data, including daily and overall continuous glucose monitoring–basedtimeinrange(TIR)(70–180 mg/dL), time in tight range (TITR) (70–140 mg/dL), and CHO entry metrics, were evaluated. RESULTS Day-to-day variability in CHO entries was negatively associated with overall TIR (P < 0.001) and TITR (P < 0.001). Higher deviation in daily CHO entry was associated with lower daily TITR and TIR (both P < 0.001). Overall TIR and TITR after AID initiation were 75.0% and 50.3%, respectively. CONCLUSIONS Variability in CHO entries is associated with lower TIR, emphasizing the importance of consistent premeal bolus routine when using AID.