ESPE Abstracts

Background: Type 1 diabetes mellitus (T1DM) is one of the most frequent chronic diseases in the pediatric age and demands constant and rigorous glycemic control. Intermittently scanned continuous glucose monitoring (isCGM) systems are a helpful tool in diabetes management. Second-generation isCGM contain alarms to assist in the detection of hyper or hypoglycemia. We aimed to compare the sleep quality of principal caregivers of T1DM pediatric patients who use isCGM with and without alarms and assess its impact on metabolic control.

Methods: An observational and cross-sectional study was carried out in March 2021, including T1DM patients who used an isCGM and a continuous subcutaneous insulin infusion device. The principal caregiver's sleep quality was assessed through the Pittsburgh Sleep Quality Index (PSQI), and metabolic control was evaluated through the ambulatory glucose profile and HbA1c level.

Results: Forty-two children and adolescents with T1DM and their caregivers were included, 14 patients using isCGM with alarms and 28 controls. The PSQI score showed no significant differences in parental sleep quality between groups: a median of 6.5 in the alarm group (IQR 7) and 9.0 in the control group (IQR 5), P=0.348. The assessment of metabolic control (adjusted to children's age and the caregivers' educational qualifications) revealed HbA1c mean of 7.93 vs 7.59 (P=0.393), time in range (TIR) 52.17% vs 42.60 % (P=0.134), time below range (TBR) 1.56% vs 5.59% (P = 0.014) and glucose coefficient of variation 35.4 vs 41.6 (P=0.004) in the groups with and without alarms, respectively. There was no significant correlation between the PSQI score and HbA1c or TIR.

Conclusions: The use of isCGM alarms did not lead to a worse sleep quality or more frequent nocturnal awakenings in caregivers of T1DM children and adolescents. However, the alarms improved metabolic control by reducing TBR and glucose CV. Thus, our results support the use of isCGM alarms in diabetes management without prejudice to the caregivers' sleep quality.