Background: Use of Continuous Glucose Monitoring (CGM) or Flash Glucose monitoring (FGM) has increased in children with type 1 diabetes without a conclusive evidence of sustained improvement in HbA1c. Aims: To assess whether use of CGM/FGM improves HbA1c. To review admissions, complications and impact on the quality of life.
Methods: Retrospective study of 33 Type 1 diabetic patients on CGM/FGM. Data collected from the case notes and Twinkle database system. A survey questionnaire was sent to parents/patients to assess the impact on quality of life.
Results: Indications for starting CGM/FGM were severe hypoglycemia, age and parental anxiety, reduced hypoglycaemic awareness, difficult glycaemic control and professional sports. Patients were divided into four baseline HbA1c cohorts, <53 mmol/mol (n=6), 5469 mmol/mol (n=17), 7085 mmol/mol (n=6) and >85 mmol/mol (n=4). Most patients in the first two cohorts showed no significant improvement or slight increase in HbA1c at 6 and 12 months. In 7085 mmol/mol cohort, 33% had significant reduction in HbA1c at 6 months (>11 mmol/mol). 100% patients with baseline HbA1c of >85 mmol/mol showed significant reduction in HbA1c at 6 months. There was a significant reduction in number of hospital admissions from diabetes related problems during the 12 months period after using CGM/FGM in comparison to the 12 months period prior to CGM/FGM use (3 vs 12, 75% reduction). On Patient/parent satisfaction survey, majority stated that they were very satisfied with the use of CGM and it improved their quality of life. 14% reported problem with signal loss and in one patient the sensor was broken and embedded in the skin requiring surgical removal.
Conclusion: Patients with baseline HbA1c >70 mmomls/mol show significant reduction in HbA1c at 6 months after starting CGM/FGM. 75% reduction in hospital admissions. Broken sensor embedded in skin requiring surgical removal is an unusual complication which has not been reported before.
27 - 29 Nov 2019
British Society for Paediatric Endocrinology and Diabetes