Long-term Continuous Glucose Monitor Use in Very Young Children With Type 1 Diabetes: One-Year Results From the SENCE Study.

Autor:	Van Name MA; Yale School of Medicine, New Haven, CT, USA., Kanapka LG; Jaeb Center for Health Research, Tampa, FL, USA., DiMeglio LA; Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA., Miller KM; Jaeb Center for Health Research, Tampa, FL, USA., Albanese-O'Neill A; Department of Pediatrics, University of Florida, Gainesville, FL, USA., Commissariat P; Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA., Corathers SD; Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA., Harrington KR; Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA., Hilliard ME; Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA., Anderson BJ; Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA., Kelley JC; Vanderbilt University Medical Center, Nashville, TN, USA., Laffel LM; Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA., MacLeish SA; Rainbow Babies and Children's Hospital, Cleveland, OH, USA., Nathan BM; University of Minnesota, Minneapolis, MN, USA., Tamborlane WV; Yale School of Medicine, New Haven, CT, USA., Wadwa RP; Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA., Willi SM; Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Williams KM; Naomi Berrie Diabetes Center, Columbia University, New York, NY, USA., Wintergerst KA; Wendy Novak Diabetes Center, University of Louisville, Norton Children's Hospital, Louisville, KY, USA., Woerner S; Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA., Wong JC; Madison Clinic for Pediatric Diabetes, University of California San Francisco, San Francisco, CA, USA., DeSalvo DJ; Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
Jazyk:	angličtina
Zdroj:	Journal of diabetes science and technology [J Diabetes Sci Technol] 2023 Jul; Vol. 17 (4), pp. 976-987. Date of Electronic Publication: 2022 Mar 26.
DOI:	10.1177/19322968221084667
Abstrakt:	Objectives: Achieving optimal glycemic outcomes in young children with type 1 diabetes (T1D) is challenging. This study examined the durability of continuous glucose monitoring (CGM) coupled with a family behavioral intervention (FBI) to improve glycemia. Study Design: This one-year study included an initial 26-week randomized controlled trial of CGM with FBI ( CGM+FBI ) and CGM alone ( Standard-CGM ) compared with blood glucose monitoring (BGM), followed by a 26-week extension phase wherein the BGM Group received the CGM+FBI ( BGM-Crossover ) and both original CGM groups continued this technology. Results: Time in range (70-180 mg/dL) did not improve with CGM use (CGM+FBI: baseline 37%, 52 weeks 41%; Standard-CGM: baseline 41%, 52 weeks 44%; BGM-Crossover: 26 weeks 38%, 52 weeks 40%). All three groups sustained decreases in hypoglycemia (<70 mg/dL) with CGM use (CGM+FBI: baseline 3.4%, 52 weeks 2.0%; Standard-CGM: baseline 4.1%, 52 weeks 2.1%; BGM-Crossover: 26 weeks 4.5%, 52 weeks 1.7%, P -values <.001). Hemoglobin A1c was unchanged with CGM use (CGM+FBI: baseline 8.3%, 52 weeks 8.2%; Standard-CGM: baseline 8.2%, 52 weeks 8.0%; BGM-Crossover: 26 weeks 8.1%, 52 weeks 8.3%). Sensor use remained high (52-week study visit: CGM+FBI 91%, Standard-CGM 92%, BGM-Crossover 88%). Conclusion: Over 12 months young children with T1D using newer CGM technology sustained reductions in hypoglycemia and, in contrast to prior studies, persistently wore CGM. However, pervasive hyperglycemia remained unmitigated. This indicates an urgent need for further advances in diabetes technology, behavioral support, and diabetes management educational approaches to optimize glycemia in young children.
Databáze:	MEDLINE
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