1902-LB: Evaluating Need for Larger Insulin Reservoir in Patch Pumps-Leveraging Retrospective Dose Data for U.S. Adults with Type 2 Diabetes on MDI

Introduction & Objective: People with T2D may require higher total daily doses (TDD) of insulin with progression to MDI. Study aim was to examine impact of different insulin reservoir sizes for adults with T2D on MDI transitioning to a patch pump. Methods: Adults (≥18 yr) with T2D on MDI (≥3 daily insulin injections) were included from the US IQVIA ambulatory electronic medical record dataset (01/2017 - 07/2022). Using mean TDD per person, we estimated number (%) of people for whom 200-unit (u) and 300u insulin reservoirs would be sufficient for different wear times and the number of patch pumps needed over time. Results: Mean ±SD TDD was 96±58u (median 80u) among 41,215 adults with T2D on MDI (52% women; mean age 58±13 yr, mean BMI 34±7 kg/m2). For 72-hr wear, 200u and 300u reservoirs were sufficient capacity for 15,612 (38%) and 26,290 (64%) adults, respectively (Figure). For 48-hr wear, 200u and 300u were sufficient for 64% and 85%, respectively, and for 24-hr wear, 94% and 99%. Number of patches needed with 200/300u reservoirs were estimated at 15/10 per mo, 176/122 per yr at mean TDD of 96u; 12/10 per mo, 147/122 per yr at median TDD of 80u; 23/15 per mo, 274/183 per yr at TDD 150u; 30/20 per mo, 366/244 per yr at TDD 200u. Conclusions: Findings provide a solid rationale for larger insulin reservoir size, providing longer wear times and fewer patches for adults with T2D on MDI transitioning to a patch pump.