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Association between Continuous Glucose Monitoring and Risk of Acute Diabetes-Related Complications in Pediatric Type

Ji Yoon Kim1, Seohyun Kim1,2, Jae Hyeon Kim1,2

  • 1Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Diabetes & Metabolism Journal
|April 21, 2026
PubMed

Insights

Continuous glucose monitoring (CGM) significantly reduces the risk of diabetic ketoacidosis (DKA) and severe hypoglycemia in children and adolescents with type 1 diabetes mellitus (T1DM). CGM use led to a substantial decrease in DKA and hypoglycemia events post-initiation.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Metabolic Disorders

Background:

  • Limited evidence exists on continuous glucose monitoring (CGM) benefits for reducing diabetes complications.
  • Diabetic ketoacidosis (DKA) and severe hypoglycemia are critical concerns in pediatric type 1 diabetes mellitus (T1DM).

Purpose of the Study:

  • To investigate the association between CGM use and the incidence of DKA and severe hypoglycemia.
  • To evaluate the impact of CGM on diabetes-related complications in pediatric T1DM patients.

Main Methods:

  • A nationwide cohort study analyzed children and adolescents (<19 years) with T1DM from 2016-2022.
  • Cox proportional hazards regression compared DKA and severe hypoglycemia risks between CGM users and non-users.
  • Paired t-tests assessed changes in DKA and hypoglycemia frequencies before and after CGM initiation.

Main Results:

  • CGM users exhibited a significantly lower risk of DKA (aHR, 0.44) and severe hypoglycemia (aHR, 0.48) compared to non-users.
  • Among CGM users, DKA frequency decreased by 64% and severe hypoglycemia by 57% after initiation (P<0.001).
  • The study included 3,765 participants (2,313 CGM users, 1,452 non-users) over a median follow-up of 2.7 years.

Conclusions:

  • Continuous glucose monitoring is associated with reduced risks of DKA and severe hypoglycemia in pediatric T1DM.
  • CGM implementation demonstrates significant protective effects against major diabetes complications in young individuals.
Abstract

Keywords:
AdolescentChildContinuous glucose monitoringDiabetes complicationsDiabetes mellitus, type 1Diabetic ketoacidosisHypoglycemia

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