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Comparative Study
. 2018 Nov;19(7):1271-1275.
doi: 10.1111/pedi.12711. Epub 2018 Jul 1.

Continuous glucose monitoring and glycemic control among youth with type 1 diabetes: International comparison from the T1D Exchange and DPV Initiative

Daniel J DeSalvo  1 , Kellee M Miller  2 , Julia M Hermann  3   4 , David M Maahs  5 , Sabine E Hofer  6 , Mark A Clements  7 , Eggert Lilienthal  8 , Jennifer L Sherr  9 , Martin Tauschmann  10 , Reinhard W Holl  3   4 ; T1D Exchange and DPV Registries
Affiliations
Comparative Study

Continuous glucose monitoring and glycemic control among youth with type 1 diabetes: International comparison from the T1D Exchange and DPV Initiative

Daniel J DeSalvo et al. Pediatr Diabetes. 2018 Nov.

Abstract

Background: To assess the change in rates of pediatric real-time or intermittent scanning continuous glucose monitoring (CGM) use over the past 5 years, and how it impacts glycemic control, data from two registries were compared: the US-based type 1 diabetes Exchange Registry (T1DX) and the German/Austrian DPV (Prospective Diabetes Follow-Up Registry).

Methods: Registry participants aged <18 years with T1D duration ≥1 year encompassed 29 007 individuals in 2011 and 29 150 participants in 2016. Demographic data, CGM use and hemoglobin A1c (HbA1c) were obtained from medical records.

Results: CGM use increased from 2011 to 2016 in both registries across all age groups, regardless of gender, ethnic minority status or insulin delivery method. The increase in CGM use was most pronounced in the youngest patients, and usage rates remain lowest for adolescent patients in 2016. For both registries in 2016, mean HbA1c was lower among CGM users regardless of insulin delivery method compared to pump only (P < 0.001) and injection only (P < 0.001), and CGM users were more likely to achieve glycemic target of HbA1c <7.5% (56% vs 43% for DPV and 30% vs 15% for T1DX, P < 0.001). T1DX participants had a higher mean HbA1c compared with DPV despite whether they were CGM users or non-users; however, the difference was less pronounced in CGM users (P < 0.001).

Conclusions: Pediatric CGM use increased in both registries and was associated with lower mean HbA1c regardless of insulin delivery modality.

Keywords: continuous glucose monitoring; longitudinal analysis; type 1 diabetes.

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Conflict of interest statement

D.J.D. is funded by the Helmsley Charitable Trust and has consulted for Dexcom and Insulet. K.M.M. and J.M.H. have no conflict of interest to report. D.M.M. is funded by the NIH (including 1P30DK116074), JDRF, NSF, and the Helmsley Charitable Trust. He is on an advisory board for Insulet, has consulted for Abbott Diabetes Care and the Helmsley Charitable Trust, and his institution has received research support or materials from Medtronic, Dexcom, Insulet, Bigfoot Biomedical, Type Zero, and Roche. S.E.H. has no conflict of interest to report. M.A.C. is funded by the NIH (including 1R01DK100779, 1DP3DK108211, 1R21HD081502, 1U01DK106984, and 1UG1HD090849), Helmsley Charitable Trust, and Jaeb Center for Health Research. He is on an advisory board for Glooko and Aegle Palette, has consulted for Eli Lilly and Medtronic, and his institution has received material support for research from Abbott Diabetes Care. E.L., J.L.S. and R.W.H. have no conflict of interest to report. M.T. has received speaker honoraria from Medtronic and NovoNordisk. The DPV Initiative has received a research grant from Abbott on the analysis of glucose variability and therefore not related to this paper.

Figures

Figure 1
Figure 1
(A) Mean HbA1c in 2016 for each registry stratified by CGM use and age group. Solid black bar represents CGM users. Solid white bar represents non‐CGM users. (B) Mean HbA1c by insulin delivery method and CGM use within each registry in 2016. BGM, blood glucose monitoring; CGM, continuous glucose monitoring or intermittent flash glucose monitoring. *P‐values compared with the reference group of pump + CGM
See this image and copyright information in PMC

References

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