Journal of Pediatrics: Clinical Practice (Dec 2024)

Impact of Continuous Glucose Monitoring on Hemoglobin A1c and Height Trends in Latin American Children with Type 1 Diabetes Onset over 3 Years: A Multicenter Study

  • Valeria Hirschler, MD,
  • Claudia Molinari, Msc,
  • Claudio D. Gonzalez, MD,
  • Maria Eugenia Andres,
  • Angela Figueroa Sobrero,
  • Victoria Femenia,
  • Guadalupe Pietropaolo,
  • Maria L. Major,
  • Edit Scaiola,
  • Sandra Mazzetti,
  • Patricia Pasayo,
  • Amanda J. Benitez,
  • Andrea Escalante Marassi,
  • Laura Pardo,
  • Julie Pelicand,
  • Carlos M. Del Aguila Villar,
  • Alejandra Franchello,
  • Ernesto Bogado,
  • Julieta Pomilio,
  • Rosa Flores,
  • Elizabeth Garcia Rusca,
  • Andrea Soledad Reinoso,
  • Analia Morin,
  • Eduardo Rossi,
  • Veronica Vacarezza,
  • Daniela Rodríguez Fuentes,
  • Paula Paz Povedano,
  • Ana L. Garcia,
  • Teresa Martinez,
  • Fabiola Blanco,
  • Oswaldo Núñez Almache,
  • Ana Parada,
  • Patricia Bocco,
  • M Laura Arzamendia,
  • Carla Mannucci,
  • Patricia Taberner,
  • Laura Braguinsky

Journal volume & issue
Vol. 14
p. 200130

Abstract

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Objective: To evaluate changes in hemoglobin A1c (HbA1c) levels and z-height over 3 years based on continuous glucose monitoring (CGM) usage among children with new-onset type 1 diabetes (T1DM) from various Latin American centers. Study design: Data on z-height, CGM access, and HbA1c (%) were collected for Latin American children aged 6 months to 18 years with T1DM onset from 19 centers in a retrospective analysis of medical records, from 2020 to 2023. A 2-way ANOVA method with repeated measures and multiple regression analyses were performed. Results: We included 433 children (46.0% female) aged 8.7 ± 3.7 years; 199 (45.9%) used CGM. The mean HbA1c was significantly lower in years 1, 2, and 3 than at baseline in children with CGM, but not those without CGM. The z-height decreased significantly with the years in both groups. However, the CGM users showed a significantly greater height in years 2 and 3 than the nonusers. Multiple linear regression analysis showed that CGM users exhibited a significantly lower incremental area under the curve (AUC) for HbA1c during follow-up than nonusers. Furthermore, a lower incremental AUC for HbA1c was associated with a smaller decremental AUC for z-height (R2 = 0.19). Multiple logistic regression analysis revealed that children with CGM were 80% more likely (OR, 0.22; 95% CI, 0.1-0.6) to achieve an HbA1c of <7% in the third year of follow-up. Conclusions: This study reveals a significant association between CGM use and lower HbA1c from the onset of T1DM over a 3-year follow-up in Latin American children. Further prospective studies should be performed to confirm this finding.

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