Objective: Real-time continuous glucose monitoring (RT-CGM) provides detailed information on glucose patterns and trends, thus allowing the patients to manage their diabetes more effectively. Design: The aim of this study was to explore the potential beneficial effects of the use of RT-CGM on diabetes management compared with self blood glucose measurement (SBGM) in patients with type 1 diabetes mellitus (T1DM), by means of a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: MEDLINE, EMBASE, and the Cochrane Library were searched through by two independent investigators for RCTs concerning the use of RT-CGM in patients with T1DM. Only studies with a similar insulin regimen in the experimental and control groups were included in the analysis. Results: Seven RCTs (nZ948) met the inclusion criteria. Combined data from all studies showed better HbA1c reduction in subjects using RT-CGM compared with those using SBGM (mean difference (MD) K0.25; 95% confidence interval (95% CI): from K0.34 to K0.17; P!0.001). Patients treated with insulin pump and RT-CGM had a lower HbA1c level compared with subjects managed with insulin pump and SBGM (four RCTs, nZ497; MD K0.26; 95% CI: from K0.43 to K0.10; PZ0.002). The benefits of applying RT-CGM were not associated with an increasing rate of major hypoglycemic episodes. The use of RT-CGM for over 60-70% of time was associated with a significant lowering of HbA1c. Conclusions: RT-CGM is more beneficial than SBGM in reducing HbA1c in patients with type 1 diabetes. Further studies are needed to evaluate the efficacy of this system in the pediatric population, especially in very young children.

Modern insulin pumps use bolus calculators to determine the appropriate insulin dose to facilitate achievement of glycaemic targets.To summarize the data on insulin pump bolus calculators compared to standard insulin dosage calculations and the impact on glycaemic profile.The MEDLINE, EMBASE and Cochrane Library databases were searched until October 2012 for related randomized controlled trials (RCTs) and observational studies performed in type 1 diabetes. A meta-analysis of RCTs was conducted.We included 6 trials comprising 354 subjects. Combined data of 2 RCTs showed significantly smaller number of correction boluses in the experimental group (MD - 2.31; 95% CI: - 3.59 to - 1.03; p=0.0004) and a trend toward fewer hypoglycaemic episodes per week (MD - 0.47; from - 0.95 to 0.02; 95% CI; p=0.06) in the experimental group compared to control subjects. Other authors reported significant reduction in daily post-prandial blood glucose values in the experimental group compared to controls. The authors observed only one adverse event. More frequent self-monitoring of blood glucose in the experimental group was reported in 3 trials. There were no differences in HbA1c within the groups. Patients were satisfied with the treatment with bolus calculator, according to the treatment satisfaction scale.Insulin pump bolus calculators are effective and safe in prandial insulin calculation with a positive impact on glucose profile.

Aim. The aim of this study was to evaluate the incidence of diabetic ketoacidosis in children and adolescents with newly diagnosed type 1 diabetes in 2006-2007 and 2013-2014. Method. The study group consisted of 426 children aged 0–18 years with type 1 diabetes onset admitted to our hospital in 2006-2007 (group A) and 2013-2014 (group B). The study comprised the analysis of medical and laboratory records from patients' medical charts and the electronic database. Results. There was no difference between groups A and B in the percentage of children admitted with diabetic ketoacidosis (25% versus 28%, resp., P = 0.499). Among children with diabetic ketoacidosis, severe metabolic decompensation (pH < 7.1) appeared in similar frequency in groups A and B (28% versus 30%, resp., P = 0.110). In group B, children with diabetic ketoacidosis were statistically younger compared to patients without ketoacidosis (P = 0.015) and had higher HbA1c levels (P = 0.006). In both groups, a 2-fold increase in diabetic ketoacidosis was noted in children under the age of 3, compared to overall frequency. Conclusion. No decrease in diabetic ketoacidosis has been noted in the recent years. Although the prevalence and severity of diabetic ketoacidosis remain stable, they are unacceptably high. The youngest children are especially prone to ketoacidosis.

The incidence of T1D in children living in eastern and central Poland increased 1.5-fold over the 5-year observation period with the highest rise in 10 to 14-year-olds and significantly higher rates in urban children compared with their peers living in rural areas.

Bolus calculator use reduces hypoglycaemic episodes independently of communication between insulin pump and blood glucose metre. Wireless communication between devices results in more frequent bolus calculator use.