Association of Sensor-Wearing Habits and Glycemic Outcomes in Pediatric Type 1 Diabetes: Analysis Using Longitudinal Glucose Sensor Data

OBJECTIVES: This study aimed to assess how children’s sensor-wearing habits affect glycemic outcomes in pediatric type 1 diabetes by analysing longitudinally collected glucose sensor data.

METHODS: A cross-sectional study was carried out in a university pediatric diabetes centre involving children (age range: 8-14 years) suffering from T1DM. In addition to sex, age, disease duration and diabetes treatment, long-term glucose sensor data for a 180-day period before the completion of the survey was retrospectively collected. The following information was derived from medical records: 180-day mean glucose value (mmol/L), coefficient of variation (CV; %), sensor wear time (SW; %), time in therapeutic range (TIR; 3.9-10.0 mmol/L), time below range (TBR; 2.2-3.8 mmol/L), time above range (TAR; 10.1-22.2 mmol/L).

RESULTS: Altogether, 84 children were involved in the study; their mean age was 11.9 (SD=1.8) years, and 47.6 % were girls. The mean duration of diabetes was significantly (p<0.001) higher in the pump+sensor group (5.8, SD=2.6 years) compared to the pen+sensor group (3.8, SD=2.0 years). The mean glucose value in the sample was 9.33 mmol/L (SD=2.13). No difference was found in glycemic outcomes between children using pump + sensor and pen + sensor. The SW significantly correlated with children’s age (r=-0.306, P=0.004), disease duration (r=-0.225, P=0.038) and TIR (r=0.254, P=0.020). The coefficient of Variation strongly correlated with TBR (r=0.633, P<0.001), but no association was found with TIR and TAR.

CONCLUSIONS: The findings of this preliminary analysis give an insight into how glycemic outcomes are related to different treatment modalities and sensor-wearing habits. The study showed that the disciplined use of glucose sensors translates into better glycemic outcomes. The results also confirmed that children with higher glucose variability spend more time outside the therapeutic range, particularly below range, and are therefore at increased risk of hypoglycaemia.