Early Use of Automated Insulin Delivery With Telehealth Support in People Recently Diagnosed With Type 1 Diabetes: One-Year Outcomes From a Prospective Observational Study.

AIMS: This study aims to evaluate the effectiveness and safety of early AID initiation combined with a telehealth support programme in individuals recently diagnosed with type 1 diabetes (T1D) in mainland China. MATERIALS AND METHODS: This prospective, single-arm, observational study sequentially enrolled individuals within 3 months of T1D diagnosis who initiated self-funded AID system with the AndroidAPS algorithm. Participants received a structured e-learning and personalised telehealth consultation during the first month followed by regular virtual follow-up. Glycaemic outcomes were assessed at 1, 3, 6, and 12 months after AID initiation. Safety outcomes included severe hypoglycaemia (SH) and diabetic ketoacidosis (DKA). RESULTS: A total of 126 participants completed at least 3 months of follow-up. Median age was 13.6 (8.9, 27.4) years and median diabetes duration was 0.9 (0.5, 1.7) months. Percentage of time in range 3.9-10.0 mmol/L (TIR) was 85.2% (80.4, 90.7) during the first month and remained stable through 12 months. Among individuals with prior CGM data (N = 93), TIR increased from 70.0% (58.6, 80.2) before AID initiation to 84.8% (79.9, 90.4) at 1 month and remained similar at 12 months. HbA1c (when available, n = 95) decreased from 10.0% (8.0, 13.4) [86 mmol/mol (64, 123)] at diagnosis to 6.3% (6.0, 6.8) [45 mmol/mol (42, 51)] at 12 months. No episodes of SH or DKA were reported. However, by the latest data update (August, 2026), the AID discontinuation rate was 35.7% (N = 45), which was mainly due to financial barriers (55.2%). CONCLUSIONS: Early self-funded AID initiation, supported by telehealth support, was associated with rapid and sustained glycaemic improvement in those recently diagnosed with T1D. Financial burden was the key challenge for consistent use of this advanced diabetes technology. TRAIL REGISTRATION: NCT06081231.