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Early Continuous Glucose Monitor Use in Children and Adolescents With Type 1 Diabetes: Rates of Initiation and Impact

Elizabeth A Mann1, Saketh Rompicherla2, Brian Miyazaki3

  • 1School of Medicine and Public Health, University of Wisconsin, Madison, WI.

Diabetes Care
|February 26, 2025
PubMed

Insights

Starting continuous glucose monitoring (CGM) within six months of type 1 diabetes (T1D) diagnosis significantly lowers hemoglobin A1c (HbA1c) levels at three years. Early CGM use in pediatric T1D patients improves long-term glycemic control.

Area of Science:

  • Pediatric Endocrinology
  • Diabetes Technology
  • Metabolic Disease Research

Background:

  • Early initiation of continuous glucose monitoring (CGM) in type 1 diabetes (T1D) is linked to better glycemic control.
  • Previous studies were limited to single institutions.

Purpose of the Study:

  • To evaluate the association between the timing of CGM initiation and hemoglobin A1c (HbA1c) levels at 3 years post-T1D diagnosis.
  • To assess long-term glycemic outcomes based on early versus delayed CGM use in a multicenter pediatric cohort.

Main Methods:

  • Utilized data from 4,164 children and adolescents (≤18 years) diagnosed with T1D in 2019-2020 from the T1D Exchange Quality Improvement Collaborative.
  • Analyzed CGM initiation timing and HbA1c at 3 years using locally estimated scatterplot smoothing and logistic regression models.
  • Controlled for potential confounding factors in the analysis.

Main Results:

  • 93% of participants initiated CGM within 3 years of diagnosis.
  • Median HbA1c at 3 years was lower for CGM initiation at 0-3 months (7.9%) and 3-6 months (7.9%) compared to 6-12 months (8.4%) and non-users (9.5%).
  • Early CGM initiation (0-3 months) showed the lowest adjusted odds of HbA1c >9%, followed by the 3-6 months group.

Conclusions:

  • Early CGM initiation within the first 6 months post-T1D diagnosis is associated with improved HbA1c outcomes at 3 years.
  • This multicenter study supports the benefit of timely CGM adoption for pediatric T1D management.
  • Prompt CGM use may lead to sustained better glycemic control in young individuals with T1D.
Abstract

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