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Increased Technology Use Associated With Lower A1C in a Large Pediatric Clinical Population

G Todd Alonso1, Taylor M Triolo1, Halis Kaan Akturk1

  • 1Barbara Davis Center, University of Colorado Anschutz Medical Campus, Aurora, CO.

Diabetes Care
|April 6, 2023
PubMed

Insights

Continuous glucose monitors (CGMs) and hybrid closed-loop (HCL) systems significantly improved glycemic control in pediatric type 1 diabetes patients. Increased adoption of these technologies correlated with lower A1C levels, highlighting their benefit in real-world care.

Area of Science:

  • Pediatric Endocrinology
  • Diabetes Technology
  • Metabolic Disease Research

Background:

  • Type 1 diabetes management in pediatrics relies on various technologies.
  • Continuous glucose monitors (CGMs), insulin pumps, and hybrid closed-loop (HCL) systems aim to improve glycemic control.
  • The real-world impact of these technologies on pediatric diabetes care requires further investigation.

Purpose of the Study:

  • To evaluate the impact of continuous glucose monitors (CGMs) and hybrid closed-loop (HCL) systems on glycemic control in pediatric patients with type 1 diabetes.
  • To assess trends in the adoption of diabetes technologies in a real-world pediatric setting.
  • To compare glycemic control outcomes based on technology usage.

Main Methods:

  • Retrospective analysis of 1,455 pediatric patients (<22 years) with type 1 diabetes.
  • Data collected from a single center across two periods: 2016-2017 and 2020-2021.
  • Patients categorized by insulin delivery method (multiple daily injections vs. insulin pump) and glucose monitoring (blood glucose monitor vs. CGM), with or without HCL system. Glycemic control (A1C) compared using linear mixed-effects models.

Main Results:

  • CGM usage rose significantly from 32.9% to 75.3% between the study periods.
  • HCL system adoption increased from 0.3% to 27.9%.
  • Overall A1C levels decreased from 8.9% to 8.6% (P < 0.0001).

Conclusions:

  • Increased adoption of CGMs and HCL systems is associated with improved glycemic control in pediatric type 1 diabetes.
  • Promoting the use of these advanced diabetes technologies may lead to significant glycemic benefits for young patients.
  • These findings support the integration of CGMs and HCL systems into routine pediatric diabetes care.
Abstract

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