Intermittently Scanned and Continuous Glucose Monitor Systems: A Systematic Review on Psychological Outcomes in Pediatric Patients

Franceschi, Roberto; Micheli, Francesca; Mozzillo, Enza; Cauvin, Vittoria; Liguori, Alice; Soffiati, Massimo; Giani, Elisa

doi:10.3389/fped.2021.660173

Cited by 25 publications

(67 citation statements)

References 61 publications

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“…We studied the impact of isCGM, started within 1 month from T1D onset, on HbA1c and QoL, as no reports on isCGM in relation to diabetes onset are available in literature (20). According to us three are the main findings:…”

Section: Discussionmentioning

confidence: 99%

Early Initiation of Intermittently Scanned Continuous Glucose Monitoring in a Pediatric Population With Type 1 Diabetes: A Real World Study

Franceschi

Cauvin²,

Stefani³

et al. 2022

Front. Endocrinol.

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BackgroundUse of Continuous Glucose Monitoring (CGM) systems early in the course of diabetes has the potential to help glycemic management and to improve quality of life (QoL). No previous research has examined these outcomes in children-adolescents with type 1 diabetes (T1D) who use intermittently scanned CGM (isCGM) starting within the first month after diagnosis.AimTo evaluate the impact of isCGM early after T1D diagnosis, on metabolic control and QoL, comparing a group who started the use of the device within one month from the onset with another one who started at least one year later.Subjects and MethodsPatients who used isCGM within 1 month from T1D diagnosis were enrolled in group A; those who didn’t have the device during the first year were considered as control group (group B). HbA1c and total daily insulin were evaluated at 3 (T1), 6 (T2) and 12 (T3) months post-baseline (T0, diabetes onset), QoL after 1 year. In group A, isCGM glucose metrics were also recorded.Results85 patients were enrolled in group A and 67 patients in group B. In group A isCGM was well accepted during follow up: no patient dropped out; percentage of time with active sensor was in mean > 87%; number of scans/day remained stable. QoL was higher in group A than in group B both in children-adolescents (p<0.0001) and in parents (p 0.003). Group A presented lower HbA1c during the first year after diagnosis (p<0.001), and this data correlated with glucose management indicator (GMI), time in range (TIR) and mean glucose. The honeymoon period lasted more in group A than in B (p 0.028). Furthermore, the mean hypoglycemia duration decreased during follow-up (p 0.001) in group A.ConclusionsEarly use of isCGM, starting within the first month after diagnosis, improves metabolic control and QoL in pediatric patients with T1D.

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Section: Discussionmentioning

confidence: 99%

Early Initiation of Intermittently Scanned Continuous Glucose Monitoring in a Pediatric Population With Type 1 Diabetes: A Real World Study

Franceschi

Cauvin²,

Stefani³

et al. 2022

Front. Endocrinol.

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“…38 However, the use of CGM can also increase family conflict and cause "alarm fatigue" in parents. 39 Additionally, hybrid closed loop systems have been documented to decrease fear of hypoglycaemia in children with type 1 diabetes, 40 and their parents. 41 Due to the possible (dis)advantages of CGM, further research is needed to determine whether advanced diabetes technologies can minimize hypoglycaemia and its impact on parents' quality of life and related outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…and the use of CGM has the potential to alleviate parents' fear of hypoglycaemia 38 . However, the use of CGM can also increase family conflict and cause “alarm fatigue” in parents 39 . Additionally, hybrid closed loop systems have been documented to decrease fear of hypoglycaemia in children with type 1 diabetes, 40 and their parents 41 .…”

Section: Discussionmentioning

confidence: 99%

The impact of hypoglycaemia in children and adolescents with type 1 diabetes on parental quality of life and related outcomes: A systematic review

et al. 2022

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This systematic review aims to summarize and critically evaluate the current evidence regarding the impact of hypoglycaemia in children and adolescents with type 1 diabetes on parental quality of life. MEDLINE, PsycINFO, CINAHL, and the Cochrane Library were searched. Inclusion criteria were: 1) quantitative design, 2) included parents of children or adolescents with type 1 diabetes, 3) assessment of hypoglycemia in children/adolescents with type 1 diabetes, 4) assessment of parent quality of life (or related domains of life), and 5) analysis of the relationship(s) between the child's hypoglycaemia and parents' quality of life. The data were summarised in accordance with Synthesis Without Meta‐Analysis Guidelines. Twelve studies were included, reporting data from 1895 parents across six countries. Ten studies were cross‐sectional; two included prospective data. Evidence suggested that greater frequency and severity of hypoglycemia was associated with greater parental fear of hypoglycemia, emotional distress and family burden. Children's hypoglycaemia has a negative impact on the well‐being of parents, but there is an absence of evidence regarding the impact on their overall quality of life. Research into the hypoglycaemia‐specific quality of life of parents is needed to explore the impact on various areas, such as social and physical dimensions.

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“…Hypoglycemia fear, alarm fatigue, family interactions, and more or less confidence in devices or diabetes distress may influence individual target setting and the choice and use of CGM. A recently published review on psychological outcomes in children using iscCGM or rtCGM clearly suggests to consider these human factors while counseling families in their choice of CGM ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

Intermittent Scanning Glucose Monitoring or Predicted Low Suspend Pump Treatment: Does It Impact Time in Glucose Target and Treatment Preference? The QUEST Randomized Crossover Study

et al. 2022

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ObjectiveTo compare glycemic control and treatment preference in children with type 1 diabetes (T1D) using sensor augmented pump (SAP) with predictive low glucose suspend (SmartGuard®) or pump with independent intermittent scanning continuous glucose monitoring (iscCGM, Freestyle libre ®).MethodsIn this open label, cross-over study, children 6 to 14 years of age, treated with insulin pump for at least 6 months, were randomized to insulin pump and iscCGM (A) or SAP with SmartGuard® (B) for 5 weeks followed by 5 additional weeks. The difference in percentages of time in glucose target (TIT), (3.9 – 8.0 mmol/l), <3 mmol/l, > 8 and 10 mmol/l, were analyzed using linear mixed models during the final week of each arm and were measured by blinded CGM (IPro2®).Results31 children (15 girls) finished the study. With sensor compliance > 60%, no difference in TIT was found, TIT: A 37.86%; 95% CI [33.21; 42.51]; B 37.20%; 95% CI [32.59; 41.82]; < 3 mmol/l A 2.27% 95% CI [0.71; 3.84] B 1.42% 95% CI [-0.13; 2.97]; > 8 mmol/l A 0.60% 95% CI [0.56, 0.67]; B 0.63% [0.56; 0.70]. One year after the study all participants were on CGM compared to 80.7% prior to the study, with a shift of 13/25 participants from iscCGM to SAP.ConclusionsIn this study, no significant difference in glycemic control was found whether treated with SAP (SmartGuard®) or pump with iscCGM. The decision of all families to continue with CGM after the study suggests a positive impact, with preference for SmartGuard®.Clinical Trial Registration[clinicaltrials.gov], identifier NCT03103867.

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Intermittently Scanned and Continuous Glucose Monitor Systems: A Systematic Review on Psychological Outcomes in Pediatric Patients

Cited by 25 publications

References 61 publications

Early Initiation of Intermittently Scanned Continuous Glucose Monitoring in a Pediatric Population With Type 1 Diabetes: A Real World Study

Early Initiation of Intermittently Scanned Continuous Glucose Monitoring in a Pediatric Population With Type 1 Diabetes: A Real World Study

The impact of hypoglycaemia in children and adolescents with type 1 diabetes on parental quality of life and related outcomes: A systematic review

Intermittent Scanning Glucose Monitoring or Predicted Low Suspend Pump Treatment: Does It Impact Time in Glucose Target and Treatment Preference? The QUEST Randomized Crossover Study

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