ESPE Abstracts (2018) 89 P-P1-076

National Survey of Usage of Continuous Glucose Monitoring in Children and Adolescents at Non Reimbursed Setting

Yuliya Bazdarskaa,b, Violeta Iotovaa,b, Vilhelm Mladenova,b, Veselin Boyadzhieva,b, Chayka Petrovac,d, Irina Halvadjianc,d, Radka Savovae, Galina Popovaf, Reni Kolevag, Mariyana Moskovah, Nartsis Kalevai,j & Diana Nedyalkovak


aUMHAT ‘St. Marina’, Varna, Bulgaria; bMedical University, Varna, Bulgaria; cUMHAT, Pleven, Bulgaria; dMedical University, Pleven, Bulgaria; eSHAT of Children’s Diseases, Sofia, Bulgaria; fTokuda Hospital, Sofia, Bulgaria; gOutpatient Clinic of Diabetology, Stara Zagora, Bulgaria; hOutpatient Clinic of Diabetology, Dobrich, Bulgaria; iUMHAT ‘St.George’, Plovdiv, Bulgaria; jMedical University, Plovdiv, Bulgaria; kOutpatient Clinic of Diabetology, Burgas, Bulgaria


Background: Continuous glucose monitoring (CGM) correlates with optimal control in both children and adults with type 1 diabetes (T1D) regardless of type of treatment. CGM plays a major role in decreasing the time spent in hypoglycemia and hyperglycemia, and achieving better quality of life.

Aim: To evaluate the usage and benefits of out-patient CGM and assess parents’ attitudes to it at a non-reimbursed setting.

Methods: A total of 984 families with child/children with T1D from 8 clinics were invited to participate in the study by filling-in an on-line or paper version short questionnaire.

Results: In total, 354 (36.0%) parents aged 39.4±6.9y, most of whom University (43.8%) and high school graduates (33.3%), responded. Mean age of the children is 11.1±3.9y (<6y. 47; 7–12y 161; 13–18y 143, 3 n.a.), with mean duration of T1D 5.5±13.6y; 180 (50.8%) are boys. According to the therapy, 283 (81.1%) are on insulin analogs, 300 on MDI and 54 on pumps. Participants measure BGL with finger pricks 4.3±2.6 times/day (sensor users vs. non users 3.2 vs. 4.5); 149 (42.1%) measure blood ketones and 44.1% check urine ketones. About one third (39.3%) have never measured ketones. Physicians prescribed glucagon in 83.6% of all. Almost half of the respondents (159, 44.9%) have used CGM at least once; 108 (30.5%) use it continuously (65 MDI, 43 pumpers). FreeStyle Libre is the most frequent (60%), followed by Dexcom G4 (26%), iPro2 (10%), and EnLite (4%). Mean HbA1c is 8.35±2.0%, and CGM users show better metabolic control (7.66% vs. 8.9%, P=0.04). HbA1c correlates with consistency of CGM usage (continuous vs. intermittent, 7.32% vs. 8.37%) and with type of therapy (Table 1). Most common reasons for CGM usage are: optimizing insulin therapy (82.3%), reducing glucose variability (65.4%), reducing hypoglycemia (56.6%), remote kid’s surveillance (56.0%), better HbA1c (52.8%), less Dawn phenomenon (50.3%) and increased independence of the child (41.5%). Patients and their families acquire information about CGMs mostly from pediatric endocrinologists (81.8%) followed by internet/groups (55.1%) and lectures (12.1%). Most families (82.5%) are discussing innovations and new technologies in T1DM with the pediatric endocrinologist; only 26.8% of them are offered support from a psychologist.

Table 1 HbA1c%.
Sensor usageContinuousIntermitentp
MDI7,438,490.0004
CSII7,067,49NS
p0.004NS

Conclision: CGM usage is increasing in prevalence at a non-reimbursed setting and shows improvement of diabetes control in T1D.