ESPE2024 Poster Category 3 Diabetes and Insulin (36 abstracts)
The Effect of Continuous Glucose Monitoring Device Assistance on Glycaemic Control in Children and Adolescents with Type 1 Diabetes Following the 2023 Türkiye Earthquake Doublet: A Multicentre Study
Gürkan Tarçın 1 , Nurgül Ataş 2 , Mevra Çay 3 , Kadriye Cansu Şahin 4 , Gül Trabzon 5 , İsmail Dündar 6 , Dilek Çiçek 7 , Hanife Gül Balkı 8 , Hayrullah Manyas 9 , Abdurrahman Bitkay 10 , Can Celiloğlu 11 , Semine Özdemir Dilek 1 , Sümeyra Kılıç 1 , Duygu Düzcan Kilimci 7 , Aysun Ata 1 , Emine Çamtosun 6 , Eda Mengen 3 , Murat Karaoğlan 2 , Bilgin Yüksel 3 & Ahmet Uçaktürk 1
1Adana City Training and Research Hospital, Adana, Turkey. 2Gaziantep University Faculty of Medicine, Gaziantep, Turkey. 3Çukurova University Faculty of Medicine, Adana, Turkey. 4Cengiz Gökçek Children's Hospital, Gaziantep, Turkey. 5Mustafa Kemal University Faculty of Medicine, Hatay, Turkey. 6İnönü University Faculty of Medicine, Malatya, Turkey. 7Mersin City Hospital, Mersin, Turkey. 8Necip Fazıl City Hospital, Kahramanmaraş, Turkey. 9Şanlıurfa Training and Reseach Hospital, Şanlıurfa, Turkey. 10Dörtyol State Hospital, Hatay, Turkey. 11Malatya Training and Research Hospital, Malatya, Turkey
Objective: The aimis to evaluate the effect of continuous glucose monitoring device (CGMD) assistance provided to the children with type 1 diabetes following the 2023 Türkiye earthquake compared with those that did not benefit from this assistance, as well as to investigate the changes in sensor parameters during 9-month usage of CGMD.
Methods: This retrospective study included 11 centres from 7 provinces in the disaster area. For all type 1 diabetic cases attending regular follow-ups, HbA1c levels in the last three months before the earthquake, as well as subsequent HbA1c levels at three-month intervals starting three months after the earthquake were recorded. Cases in the honeymoon period, using insulin pumps, and those whose first HbA1c level was at the time of diagnosis were excluded. Additionally, sensor reports of cases benefiting from CGMD assistance were examined in 3-month intervals.
Results: The study included 532 diabetic children (256 males, 276 females). A significant decrease in HbA1c levels was observed in the CGMD-using group post-earthquake, while no significant change was detected in the non-using group (Table 1). Two-way repeated measures ANOVA indicated that CGMD use significantly influenced HbA1c levels across three measured intervals: pre-earthquake, 3-6 months post-earthquake, and 9-12 months post-earthquake (F=6.298, P = 0.002). Analysis of sensor reports from 412 children revealed that 105 (25.4%) used the CGMDs irregularly, with a data acquisition ratio below 85% in at least one 3-month period; these cases were excluded from further analysis. In the remaining 307 cases, significant increases in active sensor time and average daily measurement frequency, and a significant decrease in the frequency of hypoglycemia were observed (Table 1).
| HbA1c measurements | n | Pre-earthquake HbA1c (%) | Post-earthquake HbA1c (%) | p |
| CGMD users | 263 | 8.8 (4.9-15.6) | 8.3 (5.1-15.0) | <0.001 |
| Non-users | 269 | 9.3 (5.6-16.6) | 9.5 (5.7-16.4) | 0.203 |
| Sensor parameters | First 3 months | Second three months | Third three months | p |
| Active sensor time (%) | 86.3±12.3 | 88.4±12.3 | 91.6±8.7 | <0.001 |
| Number of hypoglycaemia events | 40 (0-203) | 35 (0-192) | 34 (0-165) | <0.001 |
| Average daily measurement count | 10 (2-56) | 12 (2-92) | 23 (3-163) | <0.001 |
| Time above range (%) | 50±17 | 52±17 | 53±19 | <0.001 |
| Time in range (%) | 44±16 | 43±16 | 43±15 | 0.002 |
| Time below range (%) | 4.1±3.5 | 3.7±3.3 | 3.2±3.1 | <0.001 |
Conclusion: Despite the adverse effects of the earthquake, CGMD assistance improved glycaemic control in children with diabetes with an increase in compliance and a decrease in the frequency of hypoglycaemia over the usage period.
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