P-439: Real-world use of intermittently scanned continuous glucose monitoring in children and adolescents in a Brazilian public health system
G Vieira Ferreira Guimarães, L Garcia Miranda, T Cabral Gomes Lauand, F Franca Melo, M D Reis Borba, R K Menezes Maciel Falleiros, H Cordeiro PedrosaAbstract
Introduction
The Federal District (DF) is a pioneer in incorporating continuous glucose monitoring (CGM) into Brazil’s public health system (SUS).
Objectives
Evaluate the clinical and demographic profile, as well as the glycemic profile, of pediatric patients wearing intermittently scanned CGM sensor within a public health program.
Methods
Observational study conducted by the group from the Hospital Regional de Taguatinga (HRT) - DF, including patients aged ≤18 years and 11 months enrolled between April 2023 and April 2026. Variables included sex, type of healthcare follow-up (public vs. private) and HbA1c. CGM metrics over a six-month period were assessed, including Time in Range (TIR, 70–180 mg/dL), time below range (<70 mg/dL), and number of daily scans.
Results
From 563 records, a total of 270 were included (142 girls and 128 boys). Most (n=236) were followed in the public healthcare system. Age distribution was as follows: <2 years: 7 patients; 2–5 years: 19 patients; 6–10 years: 82 patients; 11–15 years: 95 patients; ≥16 years: 67 patients. Mean HbA1c ranged from 7.26% to 7.5%, with the highest levels observed in the 11–15 years group. The <2 years group presented the highest TIR (61.85%), but also one of the highest hypoglycemia exposures (6.71%). The ≥16 years group had the highest time in hypoglycemia (7.2%). Scan frequency was highest among younger children (15 scans/day in 2–5 years and 14 scans/day in 6–10 years) and lowest in adolescents ≥16 years (11 scans/day). Only 49 patients achieved TIR >70% and 105 achieved the recommended target of <4% time in hypoglycemia.
Conclusions
This study highlights the critical role of the Brazilian public health system in providing access to CGM for pediatric patients with type 1 diabetes. While overall glycemic control was acceptable, important gaps remain in achieving international targets for TIR and hypoglycemia, particularly among adolescents. Strategies to improve engagement and optimize CGM use are needed.