Measuring the Impact of Flash Glucose Monitoring in a Pediatric Population in Saudi Arabia: A Retrospective Cohort
Mohammed Y Alharbi1, Abdulhameed Albunyan2, Ahmad Al Nahari3
1Therapeutic Services Deputyship, Ministry of Health, Riyadh, 11176, Kingdom of Saudi Arabia. MYAl-Harbi@moh.gov.sa.
Insights
Flash glucose monitoring significantly lowers HbA1c in pediatric patients with type 1 diabetes. This continuous glucose monitoring method proves most effective for individuals with higher baseline HbA1c levels, improving glycemic control.
Area of Science:
- Endocrinology
- Diabetes Management
- Medical Technology
Background:
- Effective glycemic control is crucial for preventing diabetes complications.
- Continuous glucose monitoring (CGM) offers enhanced, around-the-clock monitoring of interstitial glucose levels.
- CGM systems improve overall glycemic control in diabetic patients.
Purpose of the Study:
- To evaluate the impact of continuous glucose monitoring (CGM) on glycated hemoglobin (HbA1c) levels.
- To assess HbA1c changes at 3, 6, and 9 months post-sensor insertion.
- To determine the efficacy of flash glucose monitoring (FGM) in pediatric and adolescent type 1 diabetes patients.
Main Methods:
- A retrospective cohort study involving 1,307 pediatric and adolescent patients with type 1 diabetes across Saudi Arabia.
- Patients used the FreeStyle® Libre flash glucose monitoring system for the first time.
- HbA1c levels were measured at baseline and at 3, 6, and 9 months post-sensor insertion.
Main Results:
- Mean HbA1c significantly decreased from 10.8% at baseline to 9.1% at 9 months (p < 0.001).
- Patients with baseline HbA1c > 9% showed a significant reduction from 11.7% to 9.5% at 9 months (p < 0.001).
- The study included a diverse cohort with a mean age of 11.1 years, 51.4% female.
Conclusions:
- Flash glucose monitoring significantly reduces HbA1c levels in pediatric and adolescent patients with type 1 diabetes.
- The greatest HbA1c reduction was observed in patients with higher baseline HbA1c levels (> 9%).
- FGM is an effective tool for improving glycemic control in this population.
Introduction:
Measurement of glucose levels is the mainstay method of ensuring good glycemic control and preventing complications associated with uncontrolled diabetes. Continuous glucose monitoring enables easy and effective monitoring of interstitial glucose around the clock and hence improves glycemic control.
Objectives:
This study aimed to measure the effect of continuous glucose monitoring on glycated hemoglobin (HbA1c) at 3, 6, and 9 months following sensor insertion.
Methods:
A retrospective cohort study of pediatric and adolescent type 1 diabetes mellitus patients randomly sampled from 32 Ministry of Health diabetes centers across Saudi Arabia was performed. Patients were subjected to flash glucose monitoring using the FreeStyle® Libre flash glucose monitoring system (Abbott Diabetes Care, Witney, UK), an intermittently scanned continuous glucose monitoring device approved by the Conformité Européenne in 2014. These patients were first-time users of any kind of continuous glucose monitoring system, aged 4-18 years, and received insulin via multiple dose injection or continuous subcutaneous insulin infusion for at least 6 months prior to study start. Patients were excluded if they had used flash glucose monitoring or other interstitial glucose monitoring systems in the past 3 months, were pregnant, or had existing hemoglobinopathies. The flash glucose monitoring sensor was attached to the back of the upper arm at the baseline visit. HbA1c (%) was measured at baseline and 3, 6, and 9 months. Patient demographics were collected from electronic health records.
Results:
1,307 patients were included, with a mean age of 11.1 years (standard deviation 3.6 years). Where specified, 51.4% were female. Mean HbA1c significantly reduced from baseline (10.8%) to 3 months (9.8%, p < 0.001), 6 months (9.2%, p < 0.001), and 9 months (9.1%, p < 0.001). For individuals with baseline HbA1c > 9%, mean HbA1c was significantly reduced from baseline (11.7%) to 3 months (10.3%, p < 0.001), 6 months (9.6%, p < 0.001), and 9 months (9.5%, p < 0.001).
Conclusions:
Flash glucose monitoring significantly reduced HbA1c levels at 3, 6, and 9 months following sensor insertion. This reduction was greatest in those patients with higher HbA1c at baseline (> 9%).
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