The Journal of Clinical Endocrinology and Metabolism Journal Article

Changes in 90-Day Time in Range Among Youth With Type 1 Diabetes Initiating Different Automated Insulin Delivery Systems

October 21, 2025

Sonia Gera, Andrew Rearson, Greyson Baker, Julia L Douvas, Nicole Alicea-Trelles, Robert J Gallop, Seema Meighan, Brynn E Marks
The Journal of Clinical Endocrinology & Metabolism, Volume 110, Issue 10, October 2025, Pages e3472–e3481
https://doi.org/10.1210/clinem/dgaf006

Abstract

Context

Glycemic outcomes in youth with type 1 diabetes (T1D) in the United States using the 2 most common automated insulin delivery (AID) systems, Insulet Omnipod 5 (OP5) and Tandem Control IQ (CIQ), have not been compared.

Objective

We performed the first head-to-head analysis of changes in glycemic metrics among youth initiating AID.

Methods

This single-center, retrospective study included youth < 21 years with T1D, who started OP5 or CIQ between January 2020 and December 2023, and had ≥ 70% continuous glucose monitoring (CGM) active time. We obtained 14-day baseline and 90-day CGM and AID data. A multiple linear regression model assessed for changes in 90-day time in range (TIR) according to AID system, adjusting for covariates. Subanalyses were conducted according to baseline TIR categories.

Results

Among the 428 included youth, there were 214 (50%) in each AID group. OP5 users had a shorter T1D duration (1.6 vs 5.5 years, P < .001) and were more likely to have transitioned from multiple daily injections (76.1% vs 20.1%, P < .001). Baseline TIR was similar between groups (OP5 51.6% vs CIQ 53.1%, P = .70). 90-day TIR increased in both groups (P < .001), rising by 11.8 percentage points (95% CI [10.4, 13.3]) in OP5 users and 9.8 percentage points (95% CI [8.3, 11.2]) in CIQ users, without any significant between-group differences (P = .08). There were no between-group differences in 90-day TIR according to categorical baseline TIR.

Conclusion

There are no clinically significant differences in 90-day TIR among youth with T1D initiating the 2 most commonly used AID systems. Patient preference and shared decision making should continue to guide the selection of AID systems.