Automated Insulin Delivery Is Associated with Reduced Hospital Admissions and Costs for Acute Diabetes Complications in Children with Type 1 Diabetes

This study evaluated the association between insulin regimen, hospitalization for acute diabetes complications, and related health care costs in children with type 1 diabetes (T1D). Hospital admissions for diabetic ketoacidosis or hypoglycemia between January 5, 2022, and April 30, 2024, were analyzed in Western Australian children with T1D. Admissions due to newly diagnosed T1D were excluded. Incidence rate ratios were calculated using generalized estimating equations, adjusted for age, diabetes duration, and socioeconomic status. Costs were valued using the 2023-2024 Australian hospital data. Among 1440 children with T1D (2674 patient-years of follow-up), admission rates per 100 patient-years were 1.98 for automated insulin delivery (AID), 3.34 for non-AID pump, and 5.86 for insulin injections, with respective costs of AUD 20,132, 34,008, and 59,574. Compared with AID, adjusted hospitalization rate ratios were 2.74 (95% confidence interval [CI]: 1.39-5.42; <i>P</i> = 0.0036) for multiple daily injections (MDI) and 1.62 (95% CI: 0.84-3.14; <i>P</i> = 0.150) for non-AID pump. AID use is associated with lower admission rates and ∼$40,000 savings per 100 patient-years compared with MDI.