UMMS Affiliation

Department of Pediatrics, Division of Endocrinology; Department of Medicine; Department of Population and Quantitative Health Sciences

Publication Date

2020-07-28

Document Type

Article

Disciplines

Endocrine System Diseases | Endocrinology, Diabetes, and Metabolism | Health Services Administration | Nutritional and Metabolic Diseases | Pediatrics

Abstract

Background:

Physiologic hyperglycemia of puberty is a major contributor to poor glycemic control in youth with type 1 diabetes (T1D). This study's aim was to determine the effectiveness of continuous glucose monitoring (CGM) to improve glycemic control in pubertal youth with T1D compared to a non-CGM cohort after controlling for age, sex, BMI, duration, and insulin delivery methodology. The hypothesis is that consistent CGM use in puberty improves compliance with diabetes management, leading to increased percentage (%) time in range (TIR70-180 mg/dL) of glycemia, and lowering of HbA1c.

Methods

A longitudinal, retrospective, case-controlled study of 105 subjects consisting of 51 T1D controls (60.8% male) age 11.5 +/- 3.8 y; and 54 T1D subjects (48.1% male) age 11.1 +/- 5.0 y with confirmed CGM use for 12 months. Pubertal status was determined by Tanner staging. Results were adjusted for baseline HbA1c and diabetes duration.

Results

HbA1c was similar between the controls and the CGM group at baseline: 8.2 +/- 1.1% vs 8.3 +/- 1.2%, p=0.48 respectively; but was significantly lower in the CGM group 12 months later, 8.2 +/- 1.1% vs. 8.7 +/- 1.4%, p=0.035. Longitudinal change in HbA1c was similar in the prepubertal cohort between the control- and CGM groups: -0.17 +/- 0.98% vs. 0.38 +/- 1.5%, p=0.17. In contrast, HbA1c increased with advancing age and pubertal status in the pubertal controls but not in the pubertal CGM group: 0.55 +/- 1.4 vs -0.22 +/- 1.1%, p=0.020. Percent TIR was inversely related to HbA1c in the CGM group, r=-0.6, p=0.0004, for both prepubertal and pubertal subjects.

Conclusions

CGM use significantly improved glycemic control in pubertal youth with T1D compared to non-CGM users.

Keywords

children, continuous glucose monitoring, hemoglobin A1c, puberty, type 1 diabetes

Rights and Permissions

© Walter de Gruyter GmbH 2020. Publisher PDF posted after a 12-month embargo as allowed by the publisher's copyright transfer agreement at https://www.degruyter.com/page/2301. The final publication is available at www.degruyter.com.

DOI of Published Version

10.1515/jpem-2020-0057

Source

Nwosu BU, Yeasmin S, Ayyoub S, Rupendu S, Villalobos-Ortiz TR, Jasmin G, Parajuli S, Zahedi B, Zitek-Morrison E, Alonso LC, Barton BA. Continuous glucose monitoring reduces pubertal hyperglycemia of type 1 diabetes. J Pediatr Endocrinol Metab. 2020 Jul 28;33(7):865-872. doi: 10.1515/jpem-2020-0057. PMID: 32634109. Link to article on publisher's site

Journal/Book/Conference Title

Journal of pediatric endocrinology and metabolism : JPEM

PubMed ID

32634109

Related Resources

Link to Article in PubMed

Available for download on Thursday, July 08, 2021

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