P-166: Impact of remote multidisciplinary education combined with isCGM on glycemic control in youth with type 1 diabetes in a public health setting
F Volpato França Sbalqueiro, A Araujo Porchat de Leão, C Kapp Fritz, F Bora Moletta, P Ferraz Hasselmann, G de Carvalho Kraemer, S Nesi-França, V Abreu Lima, M Muzzolon, H de Camargo Hermann, M Caroline Barbieri, L Christine Stansky, M Scharf Pinto, M Regina Messsagi Gomes Dias, C Choma Bettega AlmeidaAbstract
Introduction
Type 1 diabetes mellitus (T1DM) requires complex daily management, and most youth do not achieve glycemic targets. Remote education and continuous glucose monitoring (CGM) may improve outcomes, but evidence in public health settings is limited.
Objectives
To evaluate the impact of a remote multidisciplinary educational intervention combined with intermittently scanned CGM (isCGM) on glycemic control in children and adolescents with T1DM.
Methods
Prospective interventional study including 49 participants randomized to a study group (SG; n=25), receiving a 6-month telehealth-based educational program, or a control group (CG; n=24), receiving standard care. All initiated isCGM from month 3. Data were collected at baseline, 90, and 180 days.
Results
Groups were similar at baseline, with median age ∼11 years and predominantly low socioeconomic status. No significant change in HbA1c was observedover the course of the study in either group (SG: p=0.08; CG: p=0.37). After isCGM initiation, the SG showed improved glycemic metrics, including higher scan frequency (10 vs. 6.6; p=0.02), increased time in range (p=0.03), and reduced time in severe hyperglycemia (p=0.016), particularly in the second month. Differences persisted only for scan frequency in the third month (10.6 vs. 6.9; p=0.04) (Fig.1). Higher adherence to follow-up was associated with lower HbA1c (9.1% vs. 10%).Difficulties in device handling were associated with a lower percentage of active sensor time (80.7% vs. 91.8%; p = 0.05). Additionally, difficulties in attending follow-up visits (72%) were associated with poorer glycemic control (HbA1c: 9.5% vs. 8.2%; p = 0.05).
Conclusions
Telehealth-based education combined with isCGM improved selected glycemic metrics but not HbA1c. Adherence and access barriers may limit effectiveness in public health settings.