Metabolic Control of the FreeStyle Libre System in the Pediatric Population with Type 1 Diabetes Dependent on Sensor Adherence

Leiva-Gea, Isabel; Martos-Lirio, M F; Gómez-Perea, Ana; Jiménez, Ana Belén Ariza; Ceballos, L. Tapia; Jiménez-Hinojosa, Jose; López-Siguero, Juan Pedro

doi:10.3390/jcm11020286

Cited by 4 publications

(3 citation statements)

References 13 publications

(20 reference statements)

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“…A recent study on children and adolescents with T1D using isCGM showed a U-shaped relationship between daily numbers of scans count and change in glycemic control. In this study, too, the optimum number of isCGM scans was 15–20 per day [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Time in Range in Children with Type 1 Diabetes before and during a Diabetes Camp—A Ceiling Effect?

et al. 2022

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Background: The aim of this study was to assess and compare the time in range (TIR) of children with type 1 diabetes (T1D) before and during a diabetes summer camp using different therapy modalities. Methods: A retrospective analysis of continuous glucose monitoring (CGM) data collected from 26 children with T1D (mean age: 11.0 ± 1.4 years; 62% female; 62% on insulin pump; Hb1Ac 7.3 ± 0.8% (56.3 ± 8.7 mmol/mol) before and during a 14-day summer camp. CGM methods: 50% intermittently scanned CGM (isCGM) and 50% real-time CGM (rtCGM). No child was using a hybrid closed loop system. Results: Mean TIR during camp was significantly higher than before camp ((67.0 ± 10.7%) vs. 58.2% ± 17.4%, p = 0.004). There was a significant reduction in time above range (TAR) (p = 0.001) and increase in time below range (TBR) (p < 0.001), Children using isCGM showed a more pronounced improvement in TIR during camp compared to rtCGM-users (p = 0.025). The increase in TIR strongly correlated with numbers of scans per day in isCGM-users (r = 0.751, p = 0.003). Compared to isCGM-users, rtCGM-users showed significantly less TBR. The TIR target was met by 30.8% of participants during camp. Conclusion: Glycemic control improved significantly during the camp. However, on average, the therapy goal (TIR > 70%) could not be achieved despite great professional effort.

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Section: Discussionmentioning

confidence: 99%

Time in Range in Children with Type 1 Diabetes before and during a Diabetes Camp—A Ceiling Effect?

et al. 2022

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“…Three types of CGM systems are currently available: real-time CGM (rtCGM), intermittently viewed CGM (ivCGM), and intermittently scanned CGM (isCGM) [ 7 ], which were used in this study. The isCGM system provides the same type of glucose data measured with rtCGM but requires the user to purposely scan the sensor to obtain information and does not have alerts and alarms [ 8 ]. Numerous studies show that flash glucose monitoring is associated with significant improvements in HbA1c in adults and children with T1DM [ 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

The Association of Personality Traits and Parameters of Glycemic Regulation in Type 1 Diabetes Mellitus Patients Using isCGM

Rimac

Bilić-Ćurčić²,

Križevac³

et al. 2022

Healthcare

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This study aimed to examine the impact of personality on glycemic regulation in adult patients with type 1 diabetes mellitus (T1DM). The study group consisted of subjects with T1DM, who were ≥ 18 years of age. The study was conducted in two phases: At baseline, subjects completed the Croatian version of the International Personality Item Pool scale (IPIP50s) and a questionnaire designed to gather socioeconomic data, duration of diabetes, presence of chronic complications, presence of cardiovascular risk factors, frequency, and type of pre-existing hypoglycemic episodes per week. Blood and urine samples were collected and body mass index (BMI) was calculated. Each participant was provided with the intermittently scanned glucose monitoring system (isCGM) Freestyle Libre. During the second visit (3 months from the start of the trial), glycemic parameters were collected from the reports generated from the Freestyle Libre system. Estimated glycated hemoglobin (HbA1c) values were significantly lower after three months compared to baseline HbA1c (Wilcoxon test, p < 0.001). An inverse correlation between the number of daily scans and degree of extraversion among subjects was observed, e.g., higher degrees of extraversion resulted in lower numbers of daily scans, while lower degrees of extraversion, i.e., introvertedness, resulted in higher numbers of daily scans (Rho = −0.238 p = 0.009). There was a positive correlation between emotional stability and time spent in hypoglycemia (Rho = 0.214; p = 0.02). In addition, a shorter duration of diabetes was associated with higher percentages of TIR and vice versa (p = 0.02). Investigating personality traits can be a useful tool for identifying patients predisposed to hypoglycemia and lower scanning frequency. Patients with a longer history of T1DM require closer follow-up and should be re-educated when necessary.

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“…The FGM system has been proved in the Al Hayek's prospective study to improve clinical parameters once the patients had been switched from the fingerprick method to FGM over 12 weeks in children and teenagers with T1D ( 10 ). Moreover, a recent study demonstrated a significant and sustained reduction in HbA1c over 6 months in a pediatric population with FGM ( 11 ). However, none of those studies have alternated the use of FGM with SMBG.…”

Section: Introductionmentioning

confidence: 99%

Flash glucose monitoring system in patients with type 1 diabetes in healthcare center in Brazil: real world data from a short-term prospective study

Matheus¹,

Pascoal²,

Cabizuca³

et al. 2022

Archives of Endocrinology and Metabolism

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Objectives: To evaluate the alternate use of flash glucose monitoring (FGM) with self-monitoring blood glucose (SMBG), in patients with type 1 diabetes (T1D). Materials and methods: Two weeks of open FGM (P2), both preceded (P1) and followed by 2 weeks (P3) of SMBG with a blinded FGM system. Mean absolute relative difference (MARD) was calculated by (|FGMi − SMBGi|) / SMBGi, where it was a paired data sample. Results: In total, 34 patients were evaluated. Time in range (TIR) did not change between P1 and P2. In 12 patients (35.3%), TIR increased from 40% at P1 to 52% at P2 (p = 0.002) and in 22 (64.7%), TIR decreased or did not change. FGM use resulted in decreased % time spent in hypoglycemia (<70 mg/dL) (6.5% vs. 5.0%; p = 0.005), increased % time spent in hyperglycemia (>180 mg/dL) (44.5% to 51%; p = 0.046) with no significant change in % TIR. The proportion of patients who reached sensor-estimated glycated hemoglobin (eA1c) < 7% decreased from 23.5% at P1 to 12.9% at P2, p = 0.028. For the whole sample, the MARD between the two methods was 15.5% (95% CI 14.5-16.6%). For normal glucose range, hyperglycemic levels and hypoglycemic levels MARD were 16.0% (95% CI 15.0-17.0%), 13.3% (95% CI 11.5-15.2%) and 23.4% [95% CI 20.5-26.3%)], respectively. Conclusion: FGM after usual SMBG decreased the % time spent in hypoglycemia concomitant with an undesired increase in % time spent in hyperglycemia. Lower accuracy of FGM regarding hypoglycemia levels could result in overcorrection of hypoglycemia.

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Metabolic Control of the FreeStyle Libre System in the Pediatric Population with Type 1 Diabetes Dependent on Sensor Adherence

Cited by 4 publications

References 13 publications

Time in Range in Children with Type 1 Diabetes before and during a Diabetes Camp—A Ceiling Effect?

Time in Range in Children with Type 1 Diabetes before and during a Diabetes Camp—A Ceiling Effect?

The Association of Personality Traits and Parameters of Glycemic Regulation in Type 1 Diabetes Mellitus Patients Using isCGM

Flash glucose monitoring system in patients with type 1 diabetes in healthcare center in Brazil: real world data from a short-term prospective study

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