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Intermittently scanned continuous glucose monitoring is associated with high satisfaction but increased HbA1c and weight in well‐controlled youth with type 1 diabetes
Author(s) -
Charleer Sara,
Gillard Pieter,
Vandoorne Eva,
Cammaerts Kelly,
Mathieu Chantal,
Casteels Kristina
Publication year - 2020
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.13128
Subject(s) - medicine , glycemic , type 1 diabetes , observational study , absenteeism , diabetes mellitus , clinical endpoint , pediatrics , quality of life (healthcare) , metabolic control analysis , type 2 diabetes , hypoglycemia , prospective cohort study , randomized controlled trial , endocrinology , nursing , management , economics
Objective We undertook a 24‐month prospective observational single‐center real‐world trial to study impact of access to intermittently scanned continuous glucose monitoring (isCGM) on quality of life (QOL) and glycemic control of youth with type 1 diabetes (T1D). Methods Between September 2016 and November 2017, 138 children and adolescents with T1D were recruited. Demographic, metabolic, and QOL data were collected during 24 months of routine follow‐up. Primary endpoint was the evolution of QOL, with secondary outcomes change in HbA1c, occurrence of acute diabetes complications, and school absenteeism. Results Ninety‐two percent of participants found isCGM more user‐friendly than capillary finger‐stick tests and had high treatment satisfaction, without change in diabetes‐specific QOL. HbA1c significantly increased from 7.2% (7.0‐7.3) (55 mmol/mol [53‐56]) at baseline to 7.6% (7.4‐7.8) (60 mmol/mol [57‐62]) at 12 months ( P < .0001) and was unchanged up to 24 months. Overall increase was mainly driven by children with baseline HbA1c <7.0% (<53 mmol/mol). Additionally, BMI adjusted for age was higher at study end. In year before isCGM, 228 days per 100 patient‐years of school absenteeism were reported, which dramatically decreased to 13 days per 100 patient‐years ( P = .016) after 24 months. Parents of children also reported less work absenteeism ( P = .011). Conclusion The use of isCGM by T1D pediatrics is associated with high treatment satisfaction and fewer days of school absence. However, increased HbA1c and weight may reflect a looser lifestyle, with less attention to diet and more avoidance of hypoglycemia. Intensive education specifically focusing on these points may mitigate these issues.