Glucose Management in Children Living with Type 1 Diabetes: Results from the BETTER Registry

The Behaviors, Therapies, Technologies, and Hypoglycemic Risk in Type 1 Diabetes (BETTER) Registry collects patient-reported outcomes and experiences on individuals living with type 1 diabetes in Canada. The objective of our study was to describe the management of type 1 diabetes reported by parents of children and young adolescents (<14 years of age) enrolled in the BETTER registry.

We conducted a cross-sectional evaluation using self-reported data collected from April 2019 to October 2024. Parents of children and adolescents <14 years self-registered and provided online informed consent. As of October 2024, 699 children and adolescents <14 years of age and living with type 1 diabetes were enrolled.

Children had a mean age of 8.8 ± 3.1 years old with a diabetes duration of 2.3 ± 2.7 years, 44.9% were female, and 85.0% were of European ancestry. More than 80% used a continuous glucose monitoring system and 38.3% used an insulin pump. Most recent HbA1c ≤7% was reported by 15.9% of participants. At least 1 episode of level 2 hypoglycemia (glucose levels <3.0 mmol/L, with ability to self-treat) in the last month was reported by 72.5% of participants, with a median number of episodes (interquartile range) of 5 (2, 10). The occurrence of level 3 hypoglycemia (low glucose, requiring help from another person, use of glucagon, hospitalization, or loss of consciousness) in the last 12 months was reported by 8.6% of participants. Among these, the median number of episodes was 1 (1, 3).

Our results indicate that, despite a wide use of continuous glucose monitoring, the occurrence of hypoglycemia is still high and the proportion of children and adolescents reaching the HbA1c target is low.