Jessie J. Wong, United States of America
Stanford University PediatricsPresenter of 2 Presentations
EARLY INITIATION OF CONTINUOUS GLUCOSE MONITORING AMONG CHILDREN AND ADOLESCENTS: BENEFITS AND TIMING
Abstract
Background and Aims
This study sought to evaluate the impact of early continuous glucose monitoring (CGM) initiation on psychosocial functioning among children and adolescents soon after type 1 diabetes diagnosis.
Methods
The study sample included 55 youth ages 2.9-17.9 years (M=11.0, SD=3.6) and their parents. Within 40 days of diagnosis, participants were randomized to either a CGM (Dexcom G5 training and initiation) or control condition. Psychosocial survey data were collected from youth and parents at baseline and 3-, 6-, and 12-month follow-ups. Regression models tested interactions between condition assignment and days since diagnosis, adjusting for gender, age, income, and baseline A1c.
Results
A beneficial main effect (d=1.1, p=0.019) of early CGM initiation was found on youths’ hypoglycemia confidence at 1 year, with further beneficial effects on youth (d=-0.3, p=0.030) and parent (d=-1.0, p=0.048) emotional burden related to glucose monitoring, parent trust in glucose monitoring (d=1.0, p=0.046), and parent satisfaction with glucose monitoring (d=1.3, p=0.012) only among youth started on CGM after >22 days from diagnosis. Within the intervention group, early increases in youth hypoglycemia confidence (Figure 1) and parent glucose monitoring satisfaction (Figure 2) were followed by continued gains from 6- through 12-month follow-ups only for youths diagnosed with 22+ days since diagnosis, which tapered off for those with less (<22) days.
Conclusions
Early initiation of CGM use has stronger and more widespread beneficial effects when initiation occurs slightly later (more than 3 weeks) following diagnosis. Providers may consider a short delay in CGM initiation to achieve maximal long-term gains.