Feasibility and acceptability of ambulatory glucose profile in children with Type 1 diabetes mellitus: A pilot study

Abstract

Background:Insulin administration and self-monitoring of blood glucose (SMBG) are pillars in the management of diabetes in children. Introduction of continuous glucose monitoring (CGM) has made it possible to understand the glycemic profiles which are not picked up by SMBG. Recent advent of flash glucose monitoring with inbuilt software to obtain ambulatory glucose profile (AGP) has emerged as a novel method to study glycemic patterns in adults with Type I diabetes. However, the use of AGP in children is yet to be explored.Methods:AGP was used in 46 children with Type 1 diabetes mellitus. Feasibility was measured regarding data and sensor failure. Acceptability was measured using a questionnaire.Results:Forty-six children (22 girls and 24 boys) with a mean age of 10.07 years and mean diabetes duration of 3.4 years were included in the study. In this cohort, for 30 (65.21%) subjects, the sensor remained in situ for a complete duration of 14 days. Except for minor discomfort, AGP was well accepted by most of the children and their parents.Conclusion:AGP is a feasible option for monitoring glycemic status in children with diabetes with a high rate of acceptance.

Evaluation of the FreeStyle® Libre Flash Glucose Monitoring System in Children and Adolescents with Type 1 Diabetes

“…In line with earlier studies in children [24, 25, 27] and adults [20, 35], the children and/or their caregivers rated their experience with the FGM as positive. It is easy to put the sensor on and the application was painless for most of the children.…”

“…The sensor did not disturb daily activities, as washing or taking a shower, sleeping, and even sporting. The most frequently encountered inconvenience was early detachment of the sensor due to the sensor being rubbed off by clothing or trauma, which has also been reported in other studies [20, 24, 27, 35, 37]. As our study started in the summer months, sweating could have contributed to the detachment of the sensor.…”

“…Experience about the accuracy and usability in children, however, is still limited. So far, only 4 studies in children have been published [24-27]. The primary aim of the present study was to evaluate the accuracy of the FGM for estimating BG levels in children and adolescents with type 1 DM by comparing the scanned glucose result with the capillary BG value obtained by the BG meter the patients were actually using.…”

Estimating plasma glucose with the FreeStyle Libre Pro continuous glucose monitor during oral glucose tolerance tests in youth without diabetes

“…In individuals without diabetes, CGMs could help determine glycemic ranges in specific demographic samples and evaluate changes in glucose tolerance over time . In most cases, patients with diabetes have found these devices easy to use, relatively painless, and preferential to traditional finger‐prick methods of measuring glucose . However, some published literature has offered data suggesting that CGM accuracy, relative to venous measurements, may need to be adjusted for time lags and may be affected by meal macronutrient composition .…”

“…One published report found a mean absolute relative difference of the FLP system and BG reference of only 11.4% . Studies have also provided evidence suggesting that the FLP system provides acceptable glucose readings as compared to traditional glucose monitoring methods in samples of children and adults with diabetes …”