21 The diagnostic and therapeutic value of continuous glucose monitoring in children and adolescents with type 1 diabetes

Abstract

<h3>Background</h3> Type 1 diabetes represents a real public health problem whose incidence is continuously increasing. Its management must aim at maintaining an optimal glycemic control adapted to each patient (age, duration of diabetes and comorbidities). Recently, continuous glucose monitoring (CGM) has become a real mean of diabetes management. <h3>Aim of Study</h3> The objective of this work was to study the diagnostic and therapeutic interest of CGM. Methods: This is a retrospective descriptive study of 35 children and adolescents with type 1 diabetes treated with multi-injection regimen. All patients received a Medtronic iPro™2 CGM. Data collected were analyzed by SPSS 21 software. <h3>Results</h3> Thirty-five patients underwent CGM with an average duration of 6 days. The mean age of our patients was 11.6±6.6 years, with a female predominance (62.8%). The mean duration of diabetes was 4.1±3.6 years. The basal bolus regimen was used in 68.6% of patients and the insulin pump in 17.1%. The initial HBA1c (before blood glucose monitoring) was 8.9±2.6%. Glycemic instability was the main indication in 88.6% of patients, which was objectified at CGM with standard deviations greater than 50% of the mean blood glucose in 77.1% of cases. The second indication was hypoglycemia in 57.1% of cases, with time spent in hypoglycemia &gt; 5% (&lt;70 mg/dl) in 37.1% of patients. Immediately after sensor removal all patients received therapeutic adjustment. HBA1c 3 months after monitoring was 7.3±1.5%. <h3>Conclusion(s)</h3> Last studies have shown the interest of CGM in the diagnosis of glycemic excursions and asymptomatic hypoglycemia, and they have endorsed its therapeutic interest in improving glycemic control and quality of life. Our results are consistent with the literature.