Background: Self monitoring of blood glucose (SMBG) is an important part of diabetes management. Continuous glucose monitoring system (CGMS) provides the real time measurements of users glucose levels. The NICE guideline recommends use of CGMS if there is persistent hypoglycaemia unawareness or repeated hypoglycaemia or hyperglycaemia. In our paediatric diabetes clinic within a large DGH, we have a cohort of 12 children who were funded for the CGM use for a minimum of 1 year.
Objective and hypotheses: To assess the effects of CGM on metabolic control, hypoglycaemic episodes and overall compliance over a period of 12 months.
Method: Data from cohort of 12 patients who were commenced on CGMS was collected retrospectively. We compared HbA1c and frequency of hypoglycaemic episodes over 12 months. We also report their compliance and side effects related to CGMS use.
Results: 12 patients (eight males), with median age 14.5 years (518 years) used CGM over a year. There was significant improvement in the HbA1c within 1 month of usage that was sustained over 9 months (Table 1). Proportion of hypos over 12 months was reported to be low at a mean 3.8% (range 1.65.3%). There were issues with non compliance with five patients using the CGMS sensor intermittently after 8 months of continuous usage. Two of the five patients reported problems with allergy to plaster and CGM device not sticking well.
|Mean (S.D.) mmol/mol||95% Confidence Interval||P-value|
|Pre-CGM HbA1c||70.7 (13.4)|
|1 months||59.3 (10.9)||3.619.1||0.008|
|3 months||60.0 (12.9)||2.818.6||0.012|
|6 months||60.5 (11.0)||2.818.6||0.061|
|9 months||59.8 (4.2)||1.9220.0||0.022|
|12 months||64 (9.6)||−2.916.4||0.150|
Conclusion: In clinical practice use of CGMS showed improvement in control within a short period of time but this was not sustained over 12 months. Hypoglycaemic episodes were infrequent during the 12 months CGMS use. Compliance of long-term use of CGMS was low at 58% even in a healthcare that funds its use.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology