Related Experiment Video
Updated: Jun 5, 2025
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Impact of Continuous Glucose Monitoring on Hemoglobin A1c and Height Trends in Latin American Children with Type 1
Valeria Hirschler1, Claudia Molinari2, Claudio D Gonzalez3
1Argentine Diabetes Society, Epidemiology Department, Buenos Aires, Argentina.
Insights
Continuous glucose monitoring (CGM) use in children with new-onset type 1 diabetes (T1DM) is linked to lower hemoglobin A1c (HbA1c) levels over three years. CGM users also maintained better height Z-scores compared to non-users.
Area of Science:
- Pediatrics
- Endocrinology
- Metabolic Disorders
Background:
- Type 1 diabetes (T1DM) management in children requires careful monitoring of glycemic control and growth.
- Continuous glucose monitoring (CGM) offers real-time glucose data, potentially improving T1DM management.
- Growth (z-height) and glycemic control (HbA1c) are critical outcomes in pediatric T1DM.
Purpose of the Study:
- To assess the impact of CGM usage on hemoglobin A1c (HbA1c) levels and z-height in children with new-onset type 1 diabetes (T1DM).
- To evaluate these changes over a 3-year period in a Latin American cohort.
Main Methods:
- Retrospective analysis of medical records from 19 centers in Latin America (2020-2023).
- Inclusion of 433 children (6 months to 18 years) with new-onset T1DM.
- Statistical analyses included 2-way ANOVA with repeated measures and multiple regression.
Main Results:
- Children using CGM showed significantly lower HbA1c levels at 1, 2, and 3 years compared to baseline; non-users did not.
- While z-height decreased in both groups, CGM users had significantly greater height in years 2 and 3.
- CGM use was associated with an 80% higher likelihood of achieving HbA1c <7% by year 3.
Conclusions:
- CGM use is significantly associated with improved glycemic control (lower HbA1c) in children with new-onset T1DM over 3 years.
- CGM may also play a role in maintaining better growth outcomes in this population.
- Further prospective studies are recommended to confirm these findings.
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 (R 2 = 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.
Related Concept Videos
01:22Diabetes Mellitus: Type 2 and Gestational
01:15Diabetes: Symptoms, Diagnosis, and Complications
01:22Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
01:20Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
01:16Insulin: Dosing Regimen and Adverse Effects
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
01:15Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...