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. 2021 Sep;15(5):1098-1103.
doi: 10.1177/1932296820934803. Epub 2020 Jun 19.

Practical Approach to Using Trend Arrows on Real-Time Continuous Glucose Monitoring System in Type 1 Diabetes Adolescents Living Camp Setting Treated With Multiple Daily Injection or Continuous Subcutaneous Insulin Infusion Insulin Therapy

Marta Bassi  1 , Nicola Minuto  1 , Graziella Fichera  2 , Clara Rebora  1 , Alice Parodi  1 , Valentina Natoli  1 , Lidia Pontillo  3 , Marco Buccianti  4 , Giuseppe d'Annunzio  1 , Mohamad Maghnie  1
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Practical Approach to Using Trend Arrows on Real-Time Continuous Glucose Monitoring System in Type 1 Diabetes Adolescents Living Camp Setting Treated With Multiple Daily Injection or Continuous Subcutaneous Insulin Infusion Insulin Therapy

Marta Bassi et al. J Diabetes Sci Technol. 2021 Sep.

Abstract

Background: The aim of the study was to determine the effect of an educational intervention on the use of trend arrows of a real-time continuous glucose monitoring (rt-CGM) to manage daily therapy decisions in a group of adolescents with type 1 diabetes attending a camp. The secondary aim was to evaluate the variations in total daily dose (TDD) of insulin requirement.

Methods: Twenty patients (15-17 years) on multiple insulin injections (n = 8) or continuous subcutaneous insulin infusion (n = 12) attended a training session at the beginning of the camp to learn our algorithm for the management of therapy depending on trend arrows. TDD, time in range (TIR), time above range (TAR), and time below range (TBR) (in the 24 hours and in the three hours after breakfast) before the training session (run-in) and at the end of the camp (T1) were analyzed.

Results: Data showed a reduction of TAR (run-in 42.6%, T1 32.05%, P = .036) and an increase in TIR (run-in 52.9%, T1 62.4%, P = .013). Reduction of TBR (run-in 42.5%, T1 37.5%, P = .05) and improvement in TIR (run-in 49.0%, T1 57.0%, P = .02) were also observed in the post-breakfast period. Data showed a significant reduction in the TDD (run-in 52.02 ± 17.44 U/die, T1 46.49 ± 12.39 U/die, P = .024).

Conclusions: Statistically significant improvement of glycemic control and reduction of TTD were observed in all patients regardless of therapy type. The improvement between run-in and T1 demonstrates the importance of patients' education on the correct use of rt-CGM with simple algorithms for the management of therapy.

Keywords: fine-tuning; insulin dose adjustments; real-time continuous glucose monitoring; trend arrows; type 1 diabetes.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
TIR and TAR in the 24 hours at run-in and at T1. TAR, time above range; TIR, time in range.
Figure 2.
Figure 2.
TIR and TAR in the three hours post-meal at run-in and T1. TAR, time above range; TIR, time in range.
Figure 3.
Figure 3.
TDD in the 24 hours at run-in and at T1. TDD, total daily dose.
See this image and copyright information in PMC

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