The use of continuous glucose monitoring systems in a pediatric population with type 1 diabetes mellitus in real-life settings: the AWeSoMe Study Group experience
The aim of the study was (a) to compare annual glycemic control in pediatric patients with type 1 diabetes mellitus (T1DM) who used a healthcare-funded continuous glucose monitoring system (RT-CGMS) to that of those who performed self-monitoring blood glucose (SMBG) only, in a real-life setting, and (b) to define parameters associated with compliance and glycemic control.
A total of 149 youth with T1DM (52.3 % females), mean age 11.8 ± 3.6 years, and 83 in the CGMS group were followed prospectively for 12 months. Glycemic control parameters and compliance to RT-CGMS were assessed periodically.
Glycemic parameters did not differ significantly between the groups during follow-up periods. The time spent with RT-CGMS decreased and only 38 % used it for more than 75 % of the time during the 12 months (consistent users). Mean HbA1c decreased by 0.27 % in consistent users and increased by 0.21 % among intermittent users (used RT-CGMS less than 75 % of time), p = 0.013. Consistent users were younger 10. 6 ± 4.2 vs. 12.5 ± 3.6, p = 0.07, and had higher frequency of SMBG at baseline, 10.6 ± 4.9 vs. 6.3 ± 2.8, p = 0.011.
The adoption of RT-CGMS was low, even in a healthcare system that funds its use. Caregivers should consider patient characteristics when recommending RT-CGMS use.
KeywordsContinuous glucose monitoring Sensor Children Compliance HbA1c Glycemic control
- 1.Reichard P, Nilsson BY, Rosenqvist U; The Diabetes Control and Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329(5):304–309Google Scholar
- 2.The Diabetes Control and Complications Trial Research Group (1994) Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: diabetes control and complications trial. J Pediatr 125:177–188 Google Scholar
- 3.Petitti DB, Klingensmith GJ, Bell RA et al (2009) Glycemic control in youth with diabetes: the SEARCH for diabetes in Youth Study. J Pediatr 155:668–672 (e661–663)Google Scholar
- 4.Wood JR, Miller KM, Maahs DM et al (2013) Most youth with type 1 diabetes in the T1D exchange clinic registry do not meet American Diabetes Association or International Society for Pediatric and Adolescent Diabetes clinical guidelines. Diabetes Care 36(7):2035–2037 Google Scholar
- 15.Pickup JC, Freeman SC, Sutton AJ (2011) Glycaemic control in type 1 diabetes during real time continuous glucose monitoring compared with self monitoring of blood glucose: meta-analysis of randomised controlled trials using individual patient data. BMJ 343:d3805CrossRefPubMedCentralPubMedGoogle Scholar
- 16.Langendam M, Luijf YM, Hooft L, Devries JH, Mudde AH, Scholten RJ (2012) Continuous glucose monitoring systems for type 1 diabetes mellitus. Cochrane Database Syst Rev 1:CD008101Google Scholar