Short-term use of continuous glucose monitoring system adds to glycemic control in young type 1 diabetes mellitus patients in the long run: A clinical trial

Abstract

Background/Aim. Balancing strict glycemic control with setting realistic goals for each individual child and family can optimize growth, ensure normal pubertal development and emotional maturation, and control long term complications in children with type 1 diabetes (T1DM). The aim of this study was to evaluate the efficacy of short-term continuous glucose monitoring system (CGMS) application in improvement of glycemic control in pediatric type 1 diabetes mellitus (T1DM) patients. Methods. A total of 80 pediatric T1DM patients were randomly assigned into the experimental and the control group. The experimental group wore CGMS sensor for 72 hours at the beginning of the study. Self-monitored blood glucose (SMBG) levels and hemoglobin A1c (HbA1c) levels were obtained for both groups at baseline, and at 3 and 6 months. Results. There was a significant improvement in HbA1c (p < 0.001), in both the experimental and the control group, without a significant difference between the groups. Nevertheless, after 6 months the improvement of mean glycemia was noticed only in the experimental group. This finding was accompanied with a decrease in the number of hyperglycemic events and no increase in the number of hypoglycemic events in the experimental group. Conclusions. The results suggest that the CGMS can be considered as a valuable tool in treating pediatric T1DM patients, however further research is needed to more accurately estimate to what extent, if any, it outperforms intensive self-monitoring of blood glucose.Uvod/Cilj. Balansiranjem stroge glikemijske kontrole sa postavljanjem realnih ciljeva za svako pojedinacno dete i porodicu moze se optimizirati rast, odrediti normalan razvoj u pubertetu, kao i emocionalno sazrevanje i dugorocna kontrola komplikacija kod dece sa dijabetesom tip 1 (T1DM). Cilj ove studije bio je da se procijeni efikasnost metoda kontinuiranog supkutanog mjerenja glukoze u postizanju bolje glikemijske kontrole kod djece i adolescenata sa dijabetesom melitusom tip 1. Metode. Ukupno 80 djece sa dijabetesom melitusom tip 1 slucajnim odabirom odredjeno je u eksperimentalnu ili kontrolnu grupu. Ispitanici u eksperimentalnoj grupi nosili su aparat za kontinuirano pracenje glikemije (CGMS aparat) 72 sata na pocetku studije. Za ispitanike iz obje grupe evidentirani su podaci samokontrolisane glikemije (SMBG) i hemoglobina A1c (HbA1c) na pocetku studije, nakon tri i nakon sest mjeseci. Rezultati. Dobijeno je znacajno poboljsanje koncentracije HbA1c na tri i sest mjeseci i u eksperimentalnoj i kontrolnoj grupi (p < 0,001), bez znacajne razlike medju grupama. Nasuprot tome, znacajno snizenje srednje glikemije nakon sest mjeseci zabiljezeno je samo u eksperimentalnoj grupi. Nadalje, u eksperimentalnoj grupi doslo je i do smanjenje broja hiperglikemijskih dogadjaja, a, pri tom, nije evidentiran porast broja hipoglikemijskih dogadjaja. Zakljucak. Rezultati studije sugerisu da sistem kontinuiranog supkutanog pracenja glikemije moze biti korisno sredstvo metabolicke kontrole kod djece sa dijabetesom melitusom tip 1, ali neophodna su dodatna istrazivanja kako bi se preciznije utvrdilo u kojoj mjeri, ako je to uopste slucaj, ovaj metod, u terapeutskom smislu, nadmasuje intenzivno samokontrolisanje glikemije.