Endocrine Abstracts

Background: Using new technologies, such as glucose sensors and insulin pumps, may help patients with type 1 diabetes mellitus achieve better glycemic control and quality of life. With the occasion of implementing the National Program for free distribution of continuous glucose monitoring systems (CGMS) starting with January 2019, children aged under 13 years were investigated in order to assess the association between previous use of CGMS and insulin pumps and the metabolic control, evaluated by glycated haemoglobin (HbA1c).

Materials and methods: In this unicentric, cross-sectional study, we evaluated the patients aged less than 13 years, who were admitted to our Department for their first distribution of a fully reimbursed CGMS between January 1st and December 21st, 2019. Patients were divided in 4 groups, according to previous use of a CGMS (CGMS+/CGMS-) or an insulin pump (PUMP+/PUMP-). The group using an insulin pump without using a glucose sensor (CGMS-/PUMP+) was not included in the further analysis because it had only 7 subjects.

Results: The study included 167 patients, 68 girls (40.7%), mean age 9.0 ± 3.0 (range: 2.3–12.9) years, mean diabetes duration 3.8 ± 2.6 years. The CGMS-PUMP- group had 40 subjects, mean age 8.9 ± 2.6 years, mean diabetes duration 3.4 ± 2.6 years, HbA1c 7.9 ± 1.3% (63 mmol/mol). The CGMS+PUMP- had 62 subjects, mean age 9.3 ± 3.2 years (P = 0.55 vs CGMS-PUMP-), mean diabetes duration 3.4 ± 2.7 years (P = 0.95 vs CGMS-PUMP-), HbA1c 7.6 ± 1.0% (60 mmol/mol, P = 0.18 vs CGMS-PUMP-). The CGMS+PUMP+ group had 58 subjects, mean age 8.6 ± 3.1 years (P = 0.6 vs SENS-PUMP-), mean diabetes duration 4.5 ± 2.4 years (P = 0.028 vs CGMS-PUMP-), HbA1c 7.3 ± 0.8% (56 mmol/mol, P < 0.01 vs CGMS-PUMP-). The number of patients using either a CGMS or insulin pump was 127 (76% of the total number of patients)

Conclusions: Children on multiple daily insulin injections using glucose sensors had a similar metabolic control with thosewithout access to a CGMS. However, children using both insulin pump and CGMS had a significantly lower HbA1c as compared with those using none of them. We notice the remarkable high percentage of children using at least one of the technologies that we investigated. In order to achieve the best results, we recommend using the glucose sensors and insulin pumps simultaneously in children aged less than 13 years.