Continuous glucose monitoring systems in well-controlled children with type 1 diabetes mellitus

Emilia M. Kowalczyk; Marta Adamczyk; Justyna Pietrzyk; Barbara Jastrzębska; Agnieszka Szypowska

doi:10.5114/pedm.2021.107717

eISSN: 2083-8441
ISSN: 2081-237X

Pediatric Endocrinology Diabetes and Metabolism

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abstract:

Original paper

Continuous glucose monitoring systems in well-controlled children with type 1 diabetes mellitus

Emilia M. Kowalczyk

¹

,

Marta Adamczyk

²

,

Justyna Pietrzyk

²

,

Barbara Jastrzębska

²

,

Agnieszka Szypowska

³

Department of Pediatric Diabetology and Pediatrics, Pediatric Teaching Clinical Hospital of the Medical University of Warsaw, Poland
Medical University of Warsaw, Students’ Scientific Association, Poland
Department of Pediatrics, Medical University of Warsaw, Poland

Pediatr Endocrinol Diabetes Metab 2021; 27 (3): 151–158

DOI: https://doi.org/10.5114/pedm.2021.107717

Online publish date: 2021/09/21

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Introduction
Numerous studies have demonstrated the clinical benefits of using continuous glucose monitoring (CGM) systems among patients with type 1 diabetes (T1D). Aim of the study was to assess the effectiveness of CGM on metabolic control in children with T1D and well-controlled disease prior to the study.

Material and methods
This prospective analysis included 99 children (46 girls) at the median age of 11.23 years and diabetes duration of at least 1 year (median: 5.16 years), generally well controlled metabolically (median HbA1c: 7.0%), and treated with continuous subcutaneous insulin infusion (CSII). The patients had used CGM for at least 150 days. We analysed the participants in subgroups based on baseline HbA1c < 7%, ≥ 7%, age, and sex.

Results
Children with baseline HbA1c < 7% were characterized by significantly increased HbA1c after the median of 273 days (217; 320) of CGM usage (6.3% vs. 6.6%, respectively; p = 0.002). No significant change in HbA1c was noted in children with baseline HbA1c ≥ 7% (7.5% vs. 7.4%, respectively; p = 0.191), but 20% of the group reached the target of HbA1c < 7.0%. The analysis of CGM data revealed that no group achieved the CGM targets of good metabolic control. Total daily insulin requirements remained stable in both groups (p = 0.752; p = 0.274), but the amount of basal insulin increased statistically in both groups (p = 0.009; p ≤ 0.001).

Conclusions
The application of CGM provides detailed information concerning glycaemic control and is beneficial in some, but not all, T1D children with good diabetes control.

keywords:

Continuous glucose monitoring systems in well-controlled children with type 1 diabetes mellitus

Emilia M. Kowalczyk 1 , Marta Adamczyk 2 , Justyna Pietrzyk 2 , Barbara Jastrzębska 2 , Agnieszka Szypowska 3

sensor, HbA1c, glycaemic control, CGM, continuous glucose monitoring system

Emilia M. Kowalczyk

¹

,

Marta Adamczyk

²

,

Justyna Pietrzyk

²

,

Barbara Jastrzębska

²

,

Agnieszka Szypowska

³