ESPE2018 Poster Presentations Diabetes & Insulin P1 (53 abstracts)
National Survey of Usage of Continuous Glucose Monitoring in Children and Adolescents at Non Reimbursed Setting
Yuliya Bazdarska a, , Violeta Iotova a, , Vilhelm Mladenov a, , Veselin Boyadzhiev a, , Chayka Petrova c, , Irina Halvadjian c, , Radka Savova e , Galina Popova f , Reni Koleva g , Mariyana Moskova h , Nartsis Kaleva i, & Diana Nedyalkova k
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.
| Sensor usage | Continuous | Intermitent | p |
| MDI | 7,43 | 8,49 | 0.0004 |
| CSII | 7,06 | 7,49 | NS |
| p | 0.004 | NS |
Conclision: CGM usage is increasing in prevalence at a non-reimbursed setting and shows improvement of diabetes control in T1D.
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