Background and Aims

Continuous glucose monitoring (CGM) to manage diabetes mellitus in children and adolescents is widely used to control the disease. Aim: to assess the impact of CGM on metabolic compensation in type 1 diabetes mellitus in children and adolescents who are currently on continuous subcutaneous insulin infusion (CSII) based on the frequency and duration of monitoring.

Methods

A comparison of HbA1 indicators in 171 children and adolescents aged 4.5 to 18 years old who had been on insulin pump therapy for the previous three or more years was made. Data on two groups of patients were compared: Group 1 included 70 patients who used CGM permanently or no less frequently than 1 week a month; Group 2 comprised 101 patients who used CGM rarely (1-2 times a year) or did not use CGM at all.

Results

Children and adolescents of the age group who used CGM permanently or no less frequently than 1 week a month tended to have reduced levels of НbA1c compared to the children and adolescents who used no CGM or used it rarely (7.78±1.38% vs. 8.13±1.24% p>0.05) . Significantly more reduced levels of HbA1 were observed in adolescents aged 12 to 18 years old who used CGM permanently compared to adolescents who used no CGM (7.81±1.12 vs. 8.3±1.23%, p <0.05).

Conclusions

The use of CGM to manage diabetes mellitus in children and adolescents contributes to sustained metabolic compensation of the disease: the best estimates of glycemic control were seen in adolescents who used CGM permanently.

Background and Aims

To evaluate the effectiveness of treatment CSII therapy for patients with diabetes mellitus of different age groups with long-term follow-up in real clinical practice.

Methods

The total group included 239 children and adolescents with T1D on CSII for 3 years and more, including 126 (53) females and 113 (47%) males. The mean age of children was 12.8±3.5 (range from 4.5 to 18.0 years), 65% of whom were adolescents. To assess the effectiveness of treatment on HbA1c level, the total group was provisionally divided into subgroups by age: 4.5-7 years, 8-11 years, 12-18 years.

Results

The target HbA1c level (<7.5%) was found in 67% of children from 4.5-7 year age group, in 55% from 8-12 year age group, and in 35% from 12-18 year age group (p<0.001).

Conclusions

The specific group that requires attention and stricter metabolic control during the use of the insulin pump consists of adolescents older than 12 years. The essential requirement for success of the therapy is a high level of patient compliance.

In the group of adolescents (12-18 years) only 35% of patients had their HbA1c within the target. Poorer glycemic control in adolescence may be related to changes in endocrine regulation, typical to this age, as well as to psychological and social factors and the desire to become independent and free from parents.