[Usefulness of short-term usage of real time continuous glucose monitoring system in achieving metabolic control improvement in adolescents with type 1 diabetes].

INTRODUCTION: Experience with use of real-time continuous glucose monitoring systems (RT-CGMS) in teenagers with diabetes type 1 is limited, and in unselected groups of young patients did not show improvement in metabolic control.

AIM OF THE STUDY: The objective of this study was to assess short-term RT-CGMS usage in teenagers with type 1 diabetes, in terms of possibility to improve metabolic control and acceptance of the system.

MATERIAL AND METHODS: 40 subjects, aged 14.5±2 years on insulin pump therapy were included in the study. Mean diabetes duration was 6±3 years and HbA1c level before the study was 8.4±1.5%. The analysis was based on single 5-6 days long sensor usage, connected with education of the family. We analysed several parameters of glycaemic variability during the study, and HbA(1)c level before and 2 months after the study. Patients' satisfaction was assessed on the basis of a questionnaire.

RESULTS: HbA(1)c level in the whole teenagers group decreased insignificantly by 0.3%; from 8.4±1,% to 8.1±1.6%. In 24 (60%) patients we showed improvement in HbA(1)c by at least 0.5% (mean 0.9%, from 8.1±1.3% to 7.2±1.2%; p=0.03). HbA(1)c level was slightly higher in girls than in boys at the beginning of the study and a greater reduction in HbA(1)c was shown for boys. After two months the difference was significant: 8.6±1.9% in girls vs. 7.6±1.3% in boys, p=0.03. In the group with HbA(1)c decrease and in boys we demonstrated improvement in mean glycaemia and glycaemic variability parameters on the last day of the sensor usage, compared to the first day. In boys however, increased AUC <70 mg/dl/ min was noticed. The patients from the group with HbA(1)c decrease reported fewer problems with system calibration: 3.2 vs. 2.6 score, p=0.03. This group also reported higher satisfaction score connected with new knowledge: 4.0 vs. 3.5, and with quality of life: 4.1 vs. 3.6.

CONCLUSIONS: Short-term usage of RT-CGMS, combined with satisfaction questionnaire performed in teenagers with diabetes type 1 can be useful in defining the group of young patients who can benefit from RT-CGMS usage in long-term metabolic control improvement.