Continuous glucose monitoring use and glucose variability in very young children with type 1 diabetes (<scp>VibRate</scp>): A multinational prospective observational <scp>real‐world</scp> cohort study

Dovč, Klemen; Name, Michelle Van; Bizjan, Barbara Jenko; Rusak, Ewa; Piona, Claudia; Mutlu, Gül Yeşiltepe; Mentink, Rosaline; Frontino, Giulio; Macedoni, Maddalena; Ferreira, Sofia; Serra‐Caetano, Joana; Galhardo, Júlia; Pélicand, Julie; Silvestri, Francesca; Sherr, Jennifer; Chobot, Agata; Biester, Torben

doi:10.1111/dom.14607

Cited by 13 publications

(9 citation statements)

References 23 publications

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“…Since the inception of CGM, a large body of evidence from clinical trials has accumulated demonstrating efficacy of real-time and intermittently scanned CGM devices, especially if worn consistently . These results are further supported by findings from large international registries . Moreover, recent data support early adoption of CGM to improve glycemic outcomes and prevent acute complications soon after type 1 diabetes diagnosis …”

Section: Introductionmentioning

confidence: 80%

“… 8 , 9 , 10 , 11 , 12 , 13 These results are further supported by findings from large international registries. 4 , 14 , 15 , 16 , 17 Moreover, recent data support early adoption of CGM to improve glycemic outcomes and prevent acute complications soon after type 1 diabetes diagnosis. 14 , 18 , 19 …”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10][11][12][13] These results are further supported by findings from large international registries. 4,[14][15][16][17] Moreover, recent data support early adoption of CGM to improve glycemic outcomes and prevent acute complications soon after type 1 diabetes diagnosis. 14,18,19 Less is known, however, about whether different CGM modalities, especially in conjunction with an insulin pump, provide any additional benefit in achieving recommended glycemic targets beyond monitoring hemoglobin A 1c (HbA 1c ) levels.…”

Section: Introductionmentioning

confidence: 99%

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Association of Achieving Time in Range Clinical Targets With Treatment Modality Among Youths With Type 1 Diabetes

et al. 2023

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ImportanceContinuous glucose monitoring (CGM) devices have demonstrated efficacy in adults and more recently in youths and older adults with type 1 diabetes. In adults with type 1 diabetes, the use of real-time CGM compared with intermittently scanned CGM was associated with improved glycemic control, but there are limited data available for youths.ObjectiveTo assess real-world data on achievement of time in range clinical targets associated with different treatment modalities in youths with type 1 diabetes.Design, Setting, and ParticipantsThis multinational cohort study included children, adolescents, and young adults younger than 21 years (hereinafter referred to collectively as youths) with type 1 diabetes for a duration of at least 6 months who provided CGM data between January 1, 2016, and December 31, 2021. Participants were enrolled from the international Better Control in Pediatric and Adolescent Diabetes: Working to Create Centers of Reference (SWEET) registry. Data from 21 countries were included. Participants were divided into 4 treatment modalities: intermittently scanned CGM with or without insulin pump use and real-time CGM with or without insulin pump use.ExposuresType 1 diabetes and the use of CGM with or without an insulin pump.Main Outcomes and MeasuresProportion of individuals in each treatment modality group achieving recommended CGM clinical targets.ResultsAmong the 5219 participants (2714 [52.0%] male; median age, 14.4 [IQR, 11.2-17.1] years), median duration of diabetes was 5.2 (IQR, 2.7-8.7) years and median hemoglobin A1c level was 7.4% (IQR, 6.8%-8.0%). Treatment modality was associated with the proportion of individuals achieving recommended clinical targets. Adjusted for sex, age, diabetes duration, and body mass index standard deviation score, the proportion achieving the recommended greater than 70% time in range target was highest with real-time CGM plus insulin pump use (36.2% [95% CI, 33.9%-38.4%]), followed by real-time CGM plus injection use (20.9% [95% CI, 18.0%-24.1%]), intermittently scanned CGM plus injection use (12.5% [95% CI, 10.7%-14.4%]), and intermittently scanned CGM plus insulin pump use (11.3% [95% CI, 9.2%-13.8%]) (P &lt; .001). Similar trends were observed for less than 25% time above (real-time CGM plus insulin pump, 32.5% [95% CI, 30.4%-34.7%]; intermittently scanned CGM plus insulin pump, 12.8% [95% CI, 10.6%-15.4%]; P &lt; .001) and less than 4% time below range target (real-time CGM plus insulin pump, 73.1% [95% CI, 71.1%-75.0%]; intermittently scanned CGM plus insulin pump, 47.6% [95% CI, 44.1%-51.1%]; P &lt; .001). Adjusted time in range was highest among real-time CGM plus insulin pump users (64.7% [95% CI, 62.6%-66.7%]). Treatment modality was associated with the proportion of participants experiencing severe hypoglycemia and diabetic ketoacidosis events.Conclusions and RelevanceIn this multinational cohort study of youths with type 1 diabetes, concurrent use of real-time CGM and an insulin pump was associated with increased probability of achieving recommended clinical targets and time in range target as well as lower probability of severe adverse events compared with other treatment modalities.

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Section: Introductionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of Achieving Time in Range Clinical Targets With Treatment Modality Among Youths With Type 1 Diabetes

et al. 2023

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“…With use of newer systems, real‐time CGM use is high and sustained in young children with T1D and significantly reduces hypoglycemia 50 . Reduced glycemic variability was observed in real world use of CGM among a multinational cohort of young children 51 . Health care providers should counsel caregivers on how to reduce CGM‐related challenges, which can include pain from insertion, disruptive alarms, limited areas to place a sensor, skin and adhesive problems, and data overload.…”

Section: Glucose Monitoringmentioning

confidence: 99%

ISPAD Clinical Practice Consensus Guidelines 2022: Managing diabetes in preschoolers

et al. 2022

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“…Multicenter projects are of extreme importance to the ISPAD young community (JENIOUS group). [14][15][16] However, to cope with a multicenter project is not always easy. There are many people involved with different backgrounds.…”

Section: How To Manage Multicenter Projects? (Presented By Tiago Jero...mentioning

confidence: 99%

Proceedings of 21st ISPAD science school for physicians 2022

et al. 2022

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Continuous glucose monitoring use and glucose variability in very young children with type 1 diabetes (VibRate): A multinational prospective observational real‐world cohort study

Cited by 13 publications

References 23 publications

Association of Achieving Time in Range Clinical Targets With Treatment Modality Among Youths With Type 1 Diabetes

Association of Achieving Time in Range Clinical Targets With Treatment Modality Among Youths With Type 1 Diabetes

ISPAD Clinical Practice Consensus Guidelines 2022: Managing diabetes in preschoolers

Proceedings of 21st ISPAD science school for physicians 2022

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