The efficacy of outpatient monitoring of children and adolescents with type 1 diabetes with regular use of professional continuous glucose monitoring

Peterkova, Valentina; Лаптев, Д. Н.; Samoylova, Yulia; Храмова, Е. Б.; Петряйкина, Е. Е.; Рыбкина, И Г; Filimonova, Alla Yu

doi:10.14341/probl12200

Cited by 6 publications

(1 citation statement)

References 11 publications

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“…Применение профессионального НМГ при оказании медицинской помощи детям с СД1 в амбулаторных условиях статистически значимо улучшает показатели гликемического контроля, определяемые по уровню гликированного гемоглобина (НbА1с), и среднего уровня гликемии. Снижение концентрации НbА1с сопровождается статистически значимым увеличением числа пациентов с оптимальным гликемическим контролем [ 2 ][ 3 ]. При переводе пациентов на помповую инсулинотерапию при регулярном использовании НМГ также отмечается лучший ответ [ 4 ].…”

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Legal issues of the use of continuous glucose monitoring in children with type 1 diabetes

Malievskiy,

Yulchurin

2023

Probl Endokrinol (Mosk)

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Continuous glucose monitoring is an effective method of monitoring glycaemia, allowing to achieve optimal glycemic control and reduce the risk of complications of type 1 diabetes mellitus in children. After the approval of the new «Standard of medical care for children with type 1 diabetes (diagnosis and treatment)» (registered with the Ministry of Justice of Russia on 02/18/2021 No. 62543), hundreds of lawsuits were initiated in many regions of the country against regional public authorities in the field of healthcare and medical organizations demanding free supply of systems for continuous monitoring of blood glucose levels and/or sensors to them. This article analyzes the current legislation regarding the validity of the claims for free supply of disabled children with type 1 diabetes with continuous glucose monitoring.

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Legal issues of the use of continuous glucose monitoring in children with type 1 diabetes

Malievskiy,

Yulchurin

2023

Probl Endokrinol (Mosk)

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Prevalence of hypoglycemic conditions in adolescents with type 1 diabetes mellitus in real clinical practice

et al. 2022

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BACKGROUND. Hypoglycemia and fear of hypoglycemia remain critical problems in the treatment of adolescents with type 1 diabetes mellitus (DM1) and are factors limiting proper control of glycemia and preventing the achievement of metabolic compensation of the disease. The use of pump insulin therapy involves the prevention of hypoglycemic conditions.AIM. To analyze the frequency and duration of hypoglycemia episodes, their effect on the metabolic compensation of the disease in adolescents with type 1 diabetes mellitus (DM1) in real clinical practice, depending on the mode/method of insulin administration.MATERIALS AND METHODS. The study involved 117 adolescents with DM1 aged 12 to 19 years (average age 15.5 years). 37 adolescents received therapy by continuous subcutaneous insulin infusion (CSII); 80 adolescents received therapy by multiple insulin injections (MII). The level of glycated hemoglobin (HbA1c) was determined for all adolescents, and its main indicators were evaluated using a 6 days continuous glucose monitoring (CGM) by the «blind» method of a professional system with an iPro 2 sensor (Medtronic MiniMed, USA).RESULTS. Episodes of a decrease in glucose levels <3,9 mmol/l were recorded in 87% of patients (n=102), 63% (n=74) showed a decrease in glucose levels <3,0 mmol/l. Episodes decrease in glucose levels <3,9 mmol/l at night were recorded in 68% of patients (n=80), and with glucose levels <3,9 mmol/l in 46% (n=54). The frequency of episodes of glucose lowering <3,9 mmol/l had no statistically significant differences depending on the methods of insulin administration (by continuous subcutaneous insulin infusion or multiple insulin injections), however, they are more common in adolescents with HbA1c <7,0% (p=0,03). The median time spent by patients in the range of <3,9 mmol/l was 5% per day, and a longer time in this range was observed in patients with HbA1c <7,0% (p=0,006). The median time in the range of <3,0 mmol/l was 1% per day and had no significant differences depending on the level of HbA1c (p=0,559). There were also no significant differences depending on the groups using CSII and MII (p=0,640 and p=0,250).CONCLUSION. Episodes of glucose reduction in the range of <3,9 mmol/l according to CGM data are more common in adolescents with HbA1c target values, regardless of the method of insulin administration. Significantly more time in range of <3,9 mmol/l is spent by adolescents with target values of HbA1c i.е. <7,0% compared with HbA1c ≥7,0%, however, in both groups, a large number of patients had time in the range below the target level was higher than recommended values.

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Parents’ view on issues and problems of managing type 1 diabetes in children and adolescents in everyday life: results of the all-russian sociological survey “VOSHOD”

Saverskaya¹

2023

Medicinskij sovet

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Introduction. Proper education of patients and their environment is essential in achieving compensation for type 1 diabetes mellitus (T1DM).Aim. Identifying problems in T1DM management in children and adolescents in daily life and assessing the needs for educational activities for children and parents.Materials and methods. A sociological survey with the participation of 508 parents of children and adolescents with T1DM was conducted in February-April 2022 in 7 federal districts of the Russian Federation. The electronic questionnaire contained 80 questions on various areas of disease management.Results. Age of children from 3 to 18 years (average 10.7 ± 3.64 g); gender of children female – 52.2% (265), male – 47.8% (243); T1DM experience – from 1 month to 15 years (average 3.9 ± 3.2 years). Parents face problems of glycemic variability in children (19.5%), difficulties in adjusting insulin dosages (14.4%), catering in schools/kindergartens (21.0%), preferential provision of insulins and medical devices for self-control of glycemia (17.1%), age characteristics of childhood and adolescence (14.9%), psychological problems (24.4%), indifference of medical workers (10.8%), difficulties of examination for glycated hemoglobin (36.3%); low physical activity of children (57.9%), lack of knowledge and skills of proper monitoring of glycemia during physical activity (46.6%), inaccessibility of sports (22.7%). Parents receive knowledge in schools of diabetes (37.6%), from endocrinologists (42.5%), dia chats in instant messengers (70.5%), social networks (59.6%), Internet resources (77.2%) are considered an important source of information. 91.3% of parents need constant replenishment of knowledge, they consider it important to educate children and form a responsible attitude towards their health.Conclusion. The current continuing education of patients with T1DM and their environment in the management of the disease in everyday life, the solution of issues of timely and full preferential provision of children and adolescents with T1DM medical devices for monitoring glycemia and insulin preparations will contribute to increasing the effectiveness of therapy, reducing the risk of complications and improving their quality of life.

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The efficacy of outpatient monitoring of children and adolescents with type 1 diabetes with regular use of professional continuous glucose monitoring

Cited by 6 publications

References 11 publications

Legal issues of the use of continuous glucose monitoring in children with type 1 diabetes

Legal issues of the use of continuous glucose monitoring in children with type 1 diabetes

Prevalence of hypoglycemic conditions in adolescents with type 1 diabetes mellitus in real clinical practice

Parents’ view on issues and problems of managing type 1 diabetes in children and adolescents in everyday life: results of the all-russian sociological survey “VOSHOD”

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