Head-to-Head Comparison of Two Automated Insulin Delivery Systems in Children with Type 1 Diabetes during a 2-Week Summer Camp: An Exploratory Prospective Study.

INTRODUCTION: Automated insulin delivery (AID) systems offer superior glycaemic control compared to non-AID in children with type 1 diabetes, yet their performance during real-life challenges, such as summer camps with physical activity, remains underexplored. This study evaluated AID efficacy based on time range (70-180 mg/dL), comparing AID systems against sensor-augmented pump therapy (SAP) during a summer camp in children with type 1 diabetes.

METHODS: Data were collected from a 14-day diabetes camp (July 2024) involving 26 children (mean + SD age 10 ± 1.3 years), using Medtronic MiniMed 780G (n = 13), mylife CamAPS FX (n = 7), or SAP (n = 6). Continuous glucose monitoring (CGM)-derived metrics for the two AID systems and SAP were compared by means of t tests or Mann-Whitney U tests (p ≤ 0.05).

RESULTS: Both AID systems showed a similar time in range over the camp (primary endpoint, 75.5 ± 7.5% for MiniMed 780G vs. 71.1 ± 11.16% for CamAPS FX; p = 0.30). No significant differences were found for other glycaemic metrics or insulin dosage. Overnight, MiniMed 780G had less time below 54 mg/dL (0.0% [IQR: 0.0; 0.0%]) than CamAPS FX (0.4% [IQR: 0.0; 0.7%]; p = 0.024). SAP had significantly lower time in range than both AID systems (75.0% [IQR: 70.0; 81.0%] vs. 56.0% [IQR: 55.0; 66.0%]; p = 0.006). A positive correlation was found between coefficient of variation and the total number of steps (r = 0.39; p = 0.0459).

CONCLUSIONS: Despite the camp's challenges, both AID systems were safe and effective, meeting recommended CGM-derived treatment targets. Furthermore, AID systems showed superior glycaemic control compared to SAP.