Glycemic Control by Treatment Modalities: National Registry-Based Population Data in Children and Adolescents with Type 1 Diabetes.

Autor:	Šumnik Z; Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Prague, Czechia., Pavlíková M; Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics, Charles University, Prague, Czechia., Neuman V; Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Prague, Czechia., Petruželková L; Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Prague, Czechia., Konečná P; Department of Pediatrics, University Hospital Brno, Brno, Czechia., Venháčová P; Department of Pediatrics, University Hospital Olomouc, Olomouc, Czechia., Škvor J; Department of Pediatrics, Masaryk Hospital, Ústí nad Labem, Czechia., Pomahačová R; Department of Pediatrics, University Hospital Pilsen, Pilsen, Czechia., Neumann D; Department of Pediatrics, University Hospital Hradec Králové, Hradec Králové, Czechia., Vosáhlo J; Department of Pediatrics, 3rd Faculty of Medicine, Prague, Czechia., Strnadel J; Department of Pediatrics, University Hospital Ostrava, Ostrava, Czechia., Kocourková K; Department of Pediatrics, Hospital České Budějovice, České Budějovice, Czechia., Obermannová B; Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Prague, Czechia., Šantová A; Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Prague, Czechia.; 1st Faculty of Medicine, Prague, Czechia., Plachý L; Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Prague, Czechia., Průhová S; Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Prague, Czechia., Cinek O; Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Prague, Czechia.
Jazyk:	angličtina
Zdroj:	Hormone research in paediatrics [Horm Res Paediatr] 2024; Vol. 97 (1), pp. 70-79. Date of Electronic Publication: 2023 Apr 26.
DOI:	10.1159/000530833
Abstrakt:	Introduction: The aim of the study was to assess the differences in key parameters of type 1 diabetes (T1D) control associated with treatment and monitoring modalities including newly introduced hybrid closed-loop (HCL) algorithm in children and adolescents with T1D (CwD) using the data from the population-wide pediatric diabetes registry ČENDA. Methods: CwD younger than 19 years with T1D duration >1 year were included and divided according to the treatment modality and type of CGM used: multiple daily injection (MDI), insulin pump without (CSII) and with HCL function, intermittently scanned continuous glucose monitoring (isCGM), real-time CGM (rtCGM), and intermittent or no CGM (noCGM). HbA1c, times in glycemic ranges, and glucose risk index (GRI) were compared between the groups. Results: Data of a total of 3,251 children (mean age 13.4 ± 3.8 years) were analyzed. 2,187 (67.3%) were treated with MDI, 1,064 (32.7%) with insulin pump, 585/1,064 (55%) with HCL. The HCL users achieved the highest median TIR 75.4% (IQR 6.3) and lowest GRI 29.1 (7.8), both p < 0.001 compared to other groups, followed by MDI rtCGM and CSII groups with TIR 68.8% (IQR 9.0) and 69.0% (7.5), GRI 38.8 (12.5) and 40.1 (8.5), respectively (nonsignificant to each other). These three groups did not significantly differ in their HbA1c medians (51.8 [IQR 4.5], 50.7 [4.5], and 52.7 [5.7] mmol/mol, respectively). NoCGM groups had the highest HbA1c and GRI and lowest TIR regardless of the treatment modality. Conclusion: This population-based study shows that the HCL technology is superior to other treatment modalities in CGM-derived parameters and should be considered as a treatment of choice in all CwD fulfilling the indication criteria. (© 2023 The Author(s). Published by S. Karger AG, Basel.)
Databáze:	MEDLINE
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