Comparison of metabolic control in children with type 1 diabetes using reimbursed, self-funded intermittent, and self-funded continuous CGM

Aylin Gunay; Nihal Bekar; Ceylan Ates; Tulay Guran; Serap Turan; Abdullah Bereket; Belma Haliloglu

doi:10.1530/endoabs.110.P433

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Endocrine Abstracts (2025) 110 P433 | DOI: 10.1530/endoabs.110.P433

ECEESPE2025 Poster Presentations Diabetes and Insulin (143 abstracts)

Comparison of metabolic control in children with type 1 diabetes using reimbursed, self-funded intermittent, and self-funded continuous CGM

Aylin Gunay ¹ , Nihal Bekar ² , Ceylan Ates ² , Tulay Guran ² , Serap Turan ² , Abdullah Bereket ² & Belma Haliloglu ²

Author affiliations

¹Marmara University School of Medicine, Istanbul, Türkiye; ²Marmara University School of Medicine, Pediatric Endocrinology and Diabetes, Istanbul, Türkiye

JOINT2206

Aim: Although children with type 1 diabetes facing significant financial constraints are provided with reimbursed continuous glucose monitoring (CGM) systems in Turkiye, many individuals with diabetes continue to encounter socioeconomic barriers to accessing CGM technology. To mitigate these challenges, we encourage families experiencing financial difficulties to wear sensors just before their routine follow-up visits. This approach aims to enhance patient/parents’ awareness and facilitate more accurate treatment decisions. This study aims to assess differences in metabolic control among patients utilizing reimbursed CGMs, self-funded intermittent CGMs, and self-funded continuous CGMs.

Methods: Between 2021 and 2023, data from 207 CGM users were collected from CareLink, LibreView, and Clarity databases. Patients were excluded if they were in honeymoon period, used insulin pumps, had less than 14 days of CGM data, fewer than two CGMs annually, fewer than two HbA1c tests per year, or missed follow-ups. The final cohort was divided into three groups: reimbursed users (Group-1), self-funded intermittent users (Group-2), and self-funded continuous users (Group-3). Intermittent users were defined as those using sensors at least twice (10-14 days period) a year. Each group was evaluated for pre- and post-CGM one-year averages of HbA1c and anthropometric data, also groups were compared with each other in terms of one-year averages of TIR, TAR, TBR, CV.

Results: A total of 147 patients (Group-1, n = 49; Group-2, n = 43; Group-3, n = 55) were included. Pre-CGM HbA1c levels were significantly higher in Group-1 compared to Groups 2 and 3 (P < 0. 001) (Table). One year after CGM use, Group-1 still had the poorest metabolic control, but it was the only group to show a significant decrease in HbA1c. Group-3 had the lowest post-CGM HbA1c (P < 0. 0001). Although Group-3 had higher TIR value compared to Group-2, there is no statistical significance was found (P = 0, 075).

Table 1: Comparison of pre-post CGM Hba1c, TIR, TAR, TBR and CV between groups
	Group-1 (n = 49)	Group-2 (n = 43)	Group-3 (n = 55)	p
Hba1c(%), mean±SD	9. 27±2. 03	7. 72±2. 43	7. 48±1. 44	0. 0005
Post-CGM
Hba1c(%), mean±SD	8. 45±1. 22	7. 57±1. 08	7. 05±0. 76	<0. 0001
TIR(%), mean±SD	40. 49±16. 44	54. 13±17. 83	61. 37±14. 57	<0. 0001
TAR(%), mean±SD	55. 58±17. 67	40. 15±18. 85	33. 55±14. 00	<0. 0001
TBR(%), mean±SD	2. 6(0-13. 0)	3. 6(0-18. 3)	3. 2(0-12. 0)	0. 075
CV(%), mean±SD	39. 14±8. 75	40. 15±7. 11	38. 16±7. 38	0. 45
Change in Hba1c	-0. 82*	-0. 15	-0. 43
*P = 0. 0023

Conclusion: Patients with poor metabolic control benefit most from CGM systems and should be prioritized for support, regardless of glycaemic outcomes. Although not statically significant and less than those using continuous CGM, individuals using intermittent CGM showed a minimal decrease in one-year average HbA1c.

Keywords: CGM, type-1 diabetes, metabolic control