P-437: Psychosocial and glycemic outcomes during flash glucose monitoring initiation in pediatric type 1 diabetes at a tertiary public diabetes center
A S M F da Costa, L R M Tannus, R A CobasAbstract
Introduction
Flash glucose monitoring (FGM) is recommended for children with type 1 diabetes (T1D). However, psychosocial responses to the initiation of diabetes technology may vary.
Objectives
This pilot study assessed the feasibility of FGM implementation with glycemic and psychosocial outcomes.
Methods
Prospective, single-arm study of participants aged 4–18 years using the intermittent FGM System for 8 weeks. Feasibility outcomes included retention, FGM adherence, and questionnaire completion. Glycemic outcomes were assessed at baseline and after 8 weeks and included glycated hemoglobin (HbA1c), Glycemia Risk Index (GRI), time in range (TIR, 70–180 mg/dL), time above range (TAR, >180 mg/dL), and time below range (TBR, < 70 mg/dL). Psychosocial outcomes included diabetes distress (B-PAID) and quality of life (PedsQL Diabetes Module).
Results
Thirteen individuals (median age 10 years [IQR 8–14], 70% male, 85% on multiple daily injections, diabetes duration 24 months were included. Feasibility data were 95% retention, 90% adherence, 100% questionnaire completion. HbA1c decreased from 9.0% [8.3–9.7] to 8.1% [7.9–8.8] (p=0.06), and TIR, TAR, and TBR values were 47%, 46%, and 7%, respectively. Mean GRI was 67.5 ± 23 and significantly correlated with HbA1c (r=0.616, p=0.025, respectively). PedsQL scores decreased from 69.3 ± 12 to 63.8 ± 10 (p=0.027), with 46% of participants experiencing a clinically meaningful reduction of ≥ 5 points. B-PAID scores increased from 23.2 ± 10.7 to 26.3 ± 15.4 (p=0.161), and 62% showed worsening diabetes distress. No significant associations between glycemic and psychosocial outcomes emerged.
Conclusions
In our study, we concluded that, even in middle income countries intermitent FGM is feasible. Moreover, we observed correlation between GRI and HbA1c. Although glycemic control improved nonsignificantly, quality of life declined in nearly half of the participants. This dissociation highlights the need for larger studies and routine psychosocial screening during technology initiation.