The effect of do‐it‐yourself real‐time continuous glucose monitoring on psychological and glycemic variables in children with type 1 diabetes: A randomized crossover trial. Issue 4 (13th March 2022)

• Record Type: Journal Article
• Authors: Elbalshy, Mona M.; Styles, Sara; Haszard, Jillian J.; Galland, Barbara C.; Crocket, Hamish; Jefferies, Craig; Wiltshire, Esko; Tomlinson, Paul; de Bock, Martin I.; Wheeler, Benjamin J.
• Is Part Of: Pediatric diabetes. Volume 23:Issue 4(2022)
• Page Start: 480
• Page End: 488
• Publication Date: 2022-03-13
• Subjects: continuous glucose monitoring -- do‐it‐yourself -- fear of hypoglycemia -- type 1 diabetes; Diabetes in children -- Periodicals; 616.462
• DOI: 10.1111/pedi.13331
• Languages: English
• ISSNs: 1399-543X

Abstract

Abstract: Background: Continuous glucose monitoring (CGM) decreases fear of hypoglycemia (FOH) and improves glycemic control among those affected by type 1 diabetes (T1D). No studies to date have examined the impact of using do‐it‐yourself real‐time continuous glucose monitoring (DIY RT‐CGM) on psychological and glycemic outcomes. Methods: Child–parent dyads were recruited for a multicentre randomized crossover trial. Children with T1D were current intermittently scanned CGM (isCGM) users and aged 2–13 years. Families received either 6 weeks of DIY RT‐CGM with parental remote monitoring (intervention) or 6 weeks of isCGM plus usual diabetes care (control), followed by a 4‐week washout period, then crossed over. The primary outcome was parental FOH. Secondary outcomes were glycemic control using traditional CGM metrics, as well as a range of other psychosocial measures. Findings: Fifty five child–parent dyads were recruited. The child mean age was 9.1 ± 2.8 years. Although, there was no effect on parental FOH, −0.1 (95%CI: −0.3, 0.1, p = 0.4), time‐in‐range (TIR) (%3.9‐10 mmol/L) was significantly higher with DIY RT‐CGM over isCGM (54.3% ± 13.7 vs. 48.1% ± 13.6), mean difference, 5.7% (95%CI 1.8, 9.6, p <0.004). There was no difference for time spent in hypoglycemia. Parent diabetes treatment satisfaction was significantly higher following DIY RT‐CGM compared to isCGM, mean difference 5.3 (95%CI: 2.3, 8.2, p <0.001). Conclusion: The use of DIY RT‐CGM versus isCGM did not improve parental FOH; however, TIR and parental satisfaction with diabetes treatment were significantly improved. This suggests in the short term, DIY RT‐CGM appears safe and may offer families some clinically important advantages over isCGM.