P-438: Comparison of continuous glucose monitoring and self-monitoring of blood glucose for glycemic control in pediatric type 1 diabetes mellitus
M Abid, M Ibrahim, M Gul, V Rai, M RiazAbstract
Introduction
Type 1 Diabetes Mellitus (T1DM) is a chronic endocrine disorder requiring lifelong insulin therapy and vigilant glucose control. Being a chronic illness, monitoring and tight glycemic control has always been a matter of concern for both physicians and patients, especially when it comes to children and adolescents. Currently, Self-monitoring of blood glucose (SMBG) is done by an invasive method using glucometers. An alternative method for diabetes management is the emerging Continuous glucose monitoring (CGM) system. In resource-limited settings such as Pakistan, evidence on CGM use in pediatric T1DM is still limited.
Objectives
To compare the effectiveness of CGM with SMBG in improving glycemic control among children and adolescents with T1DM.
Methods
This is a quasi-experimental, single-group, pretest- posttest study, undertaken in the Pediatric Endocrinology Outpatient Department, National Institute of child health, Karachi. Forty-five children and adolescents aged 5 to 18 years with T1DM and insulin therapy of not less than 2 years as well as poor glycemic control (HbA1c >9% in the last 6 months) were recruited using a consecutive sampling. They took time to record baseline HbA1c, when participants were on SMBG. Every participant was matched to CGM over 3 months, and follow-up was provided every 15 days to adherence support and monitor the devices. Reassessment of hbA1c was at 3 months. Data was analyzed using SPSS, and paired t-test was applied.
Results
The primary outcome of the study is the change in HbA1c for recruited 45 patients from baseline to 3 months after CGM initiation. The paired t-test reveals that CGM improves glycemic control compared with prior SMBG-based monitoring in pediatric T1DM with significant results.
Conclusions
This study provides local evidence on the potential role of CGM in improving glycemic control among children with T1DM. Findings support wider adoption of CGM as a more effective and patient-friendly monitoring strategy in pediatric diabetes care.