Purpose Glucose monitoring [GM] is a mainstay of diabetes control and management. Improving glycemic control is essential to prevent microvascular complications. However, adherence to GM can be a challenge in children and adolescents. Detecting hypoglycemia is essential for its prevention and treatment. We aim to study the impact of the flash ambulatory glucose monitoring in detecting hypoglycemia and enhancing adherence in children and adolescents with type 1 diabetes. Methods The study is prospective involving 3 hospital visits. Children and adolescents with diabetes were enrolled in the study which involved a period on conventional glucose self-monitoring [glucometers] followed by a similar period of monitoring using the flash glucose monitoring device (FreeStyle Libre). Frequency of GM, duration and frequency of hypoglycemia were compared on conventional and the flash monitoring. Results 75 subjects were studied. Age mean (range) was 11.9 years (2-19). Significant difference was seen in hypoglycemia detection between both testing devices. 68 (94%) and 65 (90%) patients detected nocturnal and diurnal hypoglycemia respectively on Flash monitoring compared to 12 (16.6%) and 30 (41%) on glucometer testing (p < 0.00). Mean (range) duration of hypoglycemia was 95 min (15-330). Statistically-significant difference was found between the frequency of GM on glucometer testing compared with Flash monitoring (2.87 and 11.6/day) (p < 0.001). Conclusions Flash monitoring is a useful tool to improve adherence to GM and detecting hypoglycemia [diurnal and nocturnal] in children and adolescents with type 1 diabetes.

Background Insulin delivery triggered by a remote control is an advanced feature offered by newer insulin pump systems. These remote-integrated pump systems might further improve glycemic control and patient satisfaction. This study aims at assessing the effects of advanced insulin pump system on patients with type 1 diabetes mellitus (T1DM). Methods The prospective, observational study in two centers addressed patients on multiple daily injection (MDI) switching to an integrated pump system (primary: adolescents and young adults, secondary: school-children). Treatment and patient satisfaction parameters were recorded at baseline and at two visits at 12 and 24 weeks. Results Thirty-eight patients were analyzed; primary n = 24 (mean-age 16) and secondary n = 14 (mean-age 9). From baseline to visit2, the mean decrease of HbA1c was 1.09% ( p = 0.00009) and 0.79% ( p = 0.09) for the primary and secondary group, respectively. Patient satisfaction rate was favorable. Exploratory analyses revealed patients favoring the use of the remote control achieved best reductions in HbA1c ( p = 0.0174). Safety was encouraging with no adverse events in the period from visit1 to visit2. Conclusions Switching young T1DM patients from MDI to a remote control-integrated pump system achieved a reductions in HbA1c and insulin dose. Positive attitude towards remote operating enhanced these effects. Patient satisfaction has markedly improved. Electronic supplementary material The online version of this article (10.1186/s40842-019-0081-z) contains supplementary material, which is available to authorized users.