ESPEYB16 10. Type 1 Diabetes Mellitus (1) (20 abstracts)
10.9. Continuous glucose monitoring and glycemic control among youth with type 1 diabetes: International comparison from the T1D Exchange and DPV Initiative
DeSalvo DJ , Miller KM , Hermann JM , Maahs DM , Hofer SE , Clements MA , Lilienthal E , Sherr JL , Tauschmann M , Holl RW & T1D Exchange DPV Registries
Pediatric Endocrinology and Metabolism, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA
To read the full abstract: Pediatr Diabetes. 2018;19:1271–1275
New technologies such as continuous glucose monitoring, insulin pumps and closed-loop systems are likely to change diabetes care and hopefully will reduce the burden of disease management, decrease diabetes associated comorbidities, and increase life expectancy.
To assess the change in rates of pediatric real-time or intermittent scanning continuous glucose monitoring (CGM) use over the past 5 years, and how it impacts glycemic control, data from two different national registries were compared: the US-based type 1 diabetes Exchange Registry (T1DX) and the German/Austrian DPV (Prospective Diabetes Follow-Up Registry). Registry participants aged <18 years with T1D duration ≥1 year comprised 29,007 individuals in 2011 and 29,150 in 2016. Demographic data, CGM use and HbA1c were obtained from routine medical records.
As expected, CGM use increased from 2011 to 2016 in both registries across all age groups, regardless of gender, ethnic minority status or insulin delivery method. The increase in CGM use was most pronounced in the youngest patients, and usage rates remained lowest for adolescent patients in 2016. For both registries in 2016, mean HbA1c was lower among CGM users than non-users regardless of insulin delivery method, and CGM users were more likely to achieve glycemic target of HbA1c <7.5% (56% vs 43% for DPV and 30% vs 15% for T1DX, P<0.001). T1DX participants had a higher mean HbA1c compared with DPV despite whether they were CGM users or non-users; however, the difference was less pronounced in CGM users.
The authors conclude that pediatric CGM use increased in both USA and Germany and this was associated with lower mean HbA1c regardless of insulin delivery modality. However, it is interesting to note that despite the effects of GCM there was also a registry effect as patients in the US-based registry did less well than patients in the German registry. Hence, cultural, socioeconomic and physician-related factors are also important for obtaining good metabolic control in T1D.
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ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
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