Peculiarities of using personal continuous glucose monitoring in children and adolescents

Abstract

Recent data from the International Diabetes Federation indicated that at least 500,000 children aged 14 to 18 years worldwide have type 1 diabetes mellitus (T1DM). Currently, there is no cure for T1DM, so the goal of therapy is to achieve and maintain optimal glucose levels, in particular, using insulin therapy, physical activity, and diet. Studies of more than 20,000 children with T1DM have shown the benefits of self-monitoring of glucose levels for episodic glycemic control and long-term reduction of glycated hemoglobin (HbA1c). The purpose of our study was to investigate the specifics of using personal continuous glucose monitoring (CGM) in adolescents. Materials and methods. According to the design, the study included 22 patients (12 adolescents and 10 children) aged 8 to 16 years who were diagnosed with T1DM. Questionnaires offered included the Pediatric Quality of Life Inventory, the PedsQL Diabetes Module, the Hypoglycemia Fear Survey-II, and the Diabetes Treatment Satisfaction Questionnaire (DTSQ). Results. Before the installation of personal CGM systems, patients had average indicators of emotional, social and role functioning. It was noted that these indicators significantly increased in response to the use of personal CGM (p 0.05). We did not find a significant correlation between the level of HbA1c and the total score on the DTSQ (ρ = 0.13; p > 0.05). This indicates that satisfaction with treatment is not necessarily related to glycemic control. It was found that children who previously used personal CGM were more compliant with further use of personal CGM (p < 0.05). Among the most frequent drawbacks related to the use of personal CGM, children and their parents mentioned: discomfort from the sensor (62.19 %), the need for calibration, i.e. measuring the glucose level using a portable glucometer (58.61 %), stigmatization of the child who wears the sensor by the surrounding society (47.83 %). Conclusions. In our opinion, the use of personal CGM is appropriate and can be recommended for patients with a newly diagnosed T1DM and with a history of the disease in order to optimize therapy, improve the patient’s awareness of disease control, and increase compliance both in terms of communication with the doctor and general treatment.

Keywords

• glucose
• monitoring
• diabetes mellitus
• adolescents