P-403: Schooling model does not modify glycemic response to the summer-to-school transition: a CGM study
M Ç Karataş, İ M Erbaş, Ö Köprülü, G Akın Kağızmanlı, F Yavuzyılmaz Şimşek, H A Korkmaz, Ö Nalbantoğlu, B ÖzkanAbstract
Introduction
Although double-shift schooling is widely used in many developing countries, its effect on glycemic control in children with type 1 diabetes (T1D) is unclear.
Objectives
To evaluate whether schooling model (double-shift vs full-day) modifies the glycemic response to the transition from holiday to school in children with T1D.
Methods
This cross-sectional study included children and adolescents aged 6–18 years with T1D of at least 6 months’ duration who were using continuous glucose monitoring (CGM). CGM metrics from the last 14 days of the summer holiday and the first 14 days following school reopening (2025–2026 academic year) were analyzed. Schooling model was categorized as double-shift (morning/afternoon) or full-day education. Changes (Δ) in CGM-derived parameters were calculated as school minus holiday values. Within-subject and between-group analyses were performed.
Results
A total of 100 patients (52% female, 72% pubertal) with a mean age 13.0±3.1 years were included. Of those, 30 were in the double-shift group and 70 in the full-day schooling group. The mean HbA1c was 8.1±1.4%. During the transition from holiday to school, glycemic control deteriorated: TIR and TITR decreased, while the time >250 mg/dL and GMI increased (all p<0.001). The mean changes (Δ: school minus holiday) were −4.8±12.5% for TIR, −3.1±11.8% for TITR, +4.2±10.9% for time >250 mg/dL, and +0.3±0.7% for GMI. However, glycemic changes were comparable between the double-shift and full-day groups, with similar ΔTIR (−5.1±13.2 vs −4.6±12.2), ΔTITR (−3.4±12.5 vs −2.9±11.4), ΔTAR >250 (+4.5±11.3 vs +4.0±10.6), and ΔGMI (+0.3±0.8 vs +0.3±0.7) (all p>0.05).
Conclusions
Despite a significant deterioration in glycemic control during the transition from holiday to school, the educational model did not appear to be a major determinant of these short-term changes, suggesting that factors beyond school structure may play a more prominent role in glycemic outcomes in children with T1D.