P-61: Intermittent CGM as a clinical and psychosocial intervention in High-Risk pediatric type 1 diabetes in a Resource-Limited setting
M Hernández, N Cabral, D Hilbrink, K B Cordero, L Torres, A Gutierrez, A Matos, L Ruiz, V RamírezAbstract
Introduction
Clinically high-risk youth with type 1 diabetes (T1D) may experience marked glycemic instability that is not fully captured by HbA1c or intermittent capillary glucose testing. In resource-limited settings, restricted access to CGM may reduce detection of clinically relevant glucose fluctuations and leave families with fewer tools to understand and manage daily diabetes-related risks.
Objectives
To characterize glycemic profiles and assess the feasibility and acceptability of a combined intermittent CGM, education and psychosocial support intervention in high-risk youth with type 1 diabetes.
Methods
This prospective pilot study included five Dominican adolescents aged 12-17 years with type 1 diabetes diagnosed more than one year before enrollment. Participants underwent intermittent CGM using 3-4 FreeStyle Libre 1 and 2 sensors over four months, combined with diabetes education and psychosocial support. CGM-derived glucose metrics were analyzed descriptively. Behavioral and perceptual variables were assessed pre- and post-intervention using PAID-T, P-PAID-T and GMSS scales.
Results
Mean TIR was 26.5%, with 62.7% of time in hyperglycemia and 10.8% in hypoglycemia. Sensor satisfaction was strongly associated with lower mean glucose (r=-0.892). Parent-youth perception shifted from negative to positive alignment after the intervention (r=-0.654 to r=0.489), suggesting improved family alignment after CGM exposure and supportive education. Given the small pilot sample, these findings should be considered exploratory. No severe clinical complications were reported.
Conclusions
Intermittent CGM revealed severe, heterogeneous glycemic patterns that may be missed by conventional monitoring, with exploratory signs of improved family alignment after CGM use, education and psychosocial support. In resource-limited settings, expanding access to these tools may strengthen self-management, family engagement, and individualized care for high-risk youth with type 1 diabetes.