P-140: Impact of continuous glucose monitoring on glycemic control in pediatric type 1 diabetes in a public healthcare setting in Brazil
M Lenza Resende, A P Possar do Carmo, A Zabudowski Schroeder, D Sepúlveda Brito Barreto, V de Luna Mendes, A Pereira Foletto, B Fernandes Gavioli Sequeira, B Sannicola, B Semer Kann, L Baldini Farjalla Mattar, L Cominato, C Gouveia Buff PassoneAbstract
Introduction
FreeStyle Libre is a minimally invasive continuous glucose monitoring (CGM) system approved in Brazil for up to 14 days of use. However, due to its high cost, it is not covered by the Brazilian public healthcare system, which limits access to this technology and may negatively impact the management of type 1 diabetes mellitus.
Objectives
To assess changes in the glycemic profile over 3 and 6 months of use of the FreeStyle Libre in pediatric patients with T1D who rely on the public healthcare system.
Methods
This prospective, single-center study included pediatric patients aged 1–18 years with T1D who were transitioned from glucometer use to CGM. Patients were evaluated at baseline, 3 months, and 6 months. Assessed parameters included glycated hemoglobin (HbA1c), time in range (70–180 mg/dL), time in hypoglycemia (<70 mg/dL), body mass index (BMI), and total daily insulin dose.
Results
A total of 79 patients were included, 39 were male. Median HbA1c decreased from 9,1% (IQR 8-10.1), to 8,6% (7.6-9.8) at 3 months and 8,3 (7.2- 9.07) at 6 months (p<0,001). Mean time in range increased from 34,9% (SD 15.3) to 45.79% (SD 19. 6). Median hypoglycemia slightly decreased from 4% (1.3- 7,4) to 3% (1.25-6), p= 0,06. No changes were observed in BMI or total daily insulin dose over the study period.
Conclusions
The use of FreeStyle Libre was associated with significant improvements in glycemic control, including reduced HbA1c and increased time in range in pediatric patients with T1D. These findings support the clinical benefits of CGM and reinforce the need to expand access within public healthcare systems.