Glycemic Outcome Associated With Insulin Pump and Glucose Sensor Use in Children and Adolescents With Type 1 Diabetes. Data From the International Pediatric Registry SWEET

OBJECTIVE This study aims to examine insulin delivery methods, glucose monitoring modalities and related outcomes in a large, international, diverse cohort of children and adolescents with type 1 diabetes from the SWEET-Registry RESEARCH DESIGN AND METHODS Participants with type 1 diabetes of >1 year of duration, aged ≤18y and documented pump/sensor usage during the period August 2017-July 2019 were stratified into four categories: injections-no sensor (reference); injections+sensor; pump-no sensor; pump+sensor. HbA1c and proportion of patients with DKA or SH were analyzed; linear and logistic regression models adjusted for demographics, region and gross-domestic-product (GDP)-per capita were applied. RESULTS Data of 25,654 subjects were analyzed. Injections-no sensor: 37.44% [adjusted-HbA1c 8.72 (95%CI 8.68-8.75)]; injections+sensor: 14.98% [adjusted-HbA1c 8.30 (8.25-8.35)]; pump-no sensor: 17.22% [adjusted-HbA1c 8.07 (8.03-8.12)]; pump+sensor: 30.35% [adjusted-HbA1c 7.81 (7.77-7.84)]. HbA1c was lower in all categories of subjects using pump and/or sensor compared to injections-no sensor treatment method (p<0.001, respectively). Proportion of DKA episodes was lower in subjects with pump+sensor [1.98 (1.64-2.48); p<0.001] and pump-no sensor [2.02 (1.64-2.48); p<0.05)] when compared to injections-no sensor [2.91 (2.59-3.31)]. Proportion of SH was lower in pump-no sensor [1.10 (0.85-1.43); p<0.001] but higher in the injections+sensor [4.25 (3.65-4.95); p<0.001] compared to injections-no sensor [2.35 (2.04-2.71)]. CONCLUSIONS Lower HbA1c and fewer DKA episodes were observed in subjects using either a pump, CGM or both. Pump use was associated with lower rate of SH. Across SWEET centers, use of pumps and CGM is increasing. The concomitant use of pump and CGM was found to be associated with an additive benefit.

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Glycemic Outcome Associated With Insulin Pump and Glucose Sensor Use in Children and Adolescents With Type 1 Diabetes. Data From the International Pediatric Registry SWEET

10.2337/figshare.13746730.v1 ◽

2021 ◽

Author(s):

Roque Cardona-Hernandez ◽

Anke Schwandt ◽

Hessa Alkandari ◽

Heiko Bratke ◽

Agata Chobot ◽

...

Keyword(s):

Type 1 Diabetes ◽

Children And Adolescents ◽

Glucose Sensor ◽

Insulin Pump ◽

Glucose Monitoring ◽

Treatment Method ◽

Logistic Regression Models ◽

Design And Methods ◽

No Sensor

OBJECTIVE This study aims to examine insulin delivery methods, glucose monitoring modalities and related outcomes in a large, international, diverse cohort of children and adolescents with type 1 diabetes from the SWEET-Registry RESEARCH DESIGN AND METHODS Participants with type 1 diabetes of >1 year of duration, aged ≤18y and documented pump/sensor usage during the period August 2017-July 2019 were stratified into four categories: injections-no sensor (reference); injections+sensor; pump-no sensor; pump+sensor. HbA1c and proportion of patients with DKA or SH were analyzed; linear and logistic regression models adjusted for demographics, region and gross-domestic-product (GDP)-per capita were applied. RESULTS Data of 25,654 subjects were analyzed. Injections-no sensor: 37.44% [adjusted-HbA1c 8.72 (95%CI 8.68-8.75)]; injections+sensor: 14.98% [adjusted-HbA1c 8.30 (8.25-8.35)]; pump-no sensor: 17.22% [adjusted-HbA1c 8.07 (8.03-8.12)]; pump+sensor: 30.35% [adjusted-HbA1c 7.81 (7.77-7.84)]. HbA1c was lower in all categories of subjects using pump and/or sensor compared to injections-no sensor treatment method (p<0.001, respectively). Proportion of DKA episodes was lower in subjects with pump+sensor [1.98 (1.64-2.48); p<0.001] and pump-no sensor [2.02 (1.64-2.48); p<0.05)] when compared to injections-no sensor [2.91 (2.59-3.31)]. Proportion of SH was lower in pump-no sensor [1.10 (0.85-1.43); p<0.001] but higher in the injections+sensor [4.25 (3.65-4.95); p<0.001] compared to injections-no sensor [2.35 (2.04-2.71)]. CONCLUSIONS Lower HbA1c and fewer DKA episodes were observed in subjects using either a pump, CGM or both. Pump use was associated with lower rate of SH. Across SWEET centers, use of pumps and CGM is increasing. The concomitant use of pump and CGM was found to be associated with an additive benefit.

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Evaluation of a novel tool to adjust insulin boluses based on continuous glucose monitoring trend arrows and insulin sensitivity (trend arrow adjustment tool) in children and adolescents with type 1 diabetes using insulin pump therapy

Endocrine Abstracts ◽

10.1530/endoabs.39.ep46 ◽

2015 ◽

Author(s):

Emmeline Heffernan ◽

Margaret Lawson ◽

Brenda Bradley ◽

Jennilea Courtney ◽

Christine Richardson

Keyword(s):

Type 1 Diabetes ◽

Insulin Sensitivity ◽

Children And Adolescents ◽

Continuous Glucose Monitoring ◽

Insulin Pump ◽

Glucose Monitoring ◽

Insulin Pump Therapy ◽

Pump Therapy

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Use of Integrated Real-Time Continuous Glucose Monitoring/Insulin Pump System in Children and Adolescents with Type 1 Diabetes: A 3-Year Follow-Up Study

Diabetes Technology & Therapeutics ◽

10.1089/dia.2010.0119 ◽

2011 ◽

Vol 13 (2) ◽

pp. 99-103 ◽

Cited By ~ 22

Author(s):

Andrea E. Scaramuzza ◽

Dario Iafusco ◽

Ivana Rabbone ◽

Riccardo Bonfanti ◽

Fortunato Lombardo ◽

...

Keyword(s):

Type 1 Diabetes ◽

Children And Adolescents ◽

Real Time ◽

Continuous Glucose Monitoring ◽

Insulin Pump ◽

Glucose Monitoring ◽

Pump System ◽

Follow Up Study

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Lessons Learned From a Pilot RCT of Simultaneous Versus Delayed Initiation of Continuous Glucose Monitoring in Children and Adolescents With Type 1 Diabetes Starting Insulin Pump Therapy

Journal of Diabetes Science and Technology ◽

10.1177/1932296814524855 ◽

2014 ◽

Vol 8 (3) ◽

pp. 523-528 ◽

Cited By ~ 8

Author(s):

Patricia Olivier ◽

Margaret L. Lawson ◽

Celine Huot ◽

Christine Richardson ◽

Meranda Nakhla ◽

...

Keyword(s):

Type 1 Diabetes ◽

Children And Adolescents ◽

Insulin Pump ◽

Glucose Monitoring ◽

Lessons Learned ◽

Insulin Pump Therapy ◽

Pump Therapy ◽

Delayed Initiation ◽

Pilot Rct

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Glucose Monitoring and Insulin Pump Therapy in the Management of Children and Adolescents with Type 1 Diabetes

Research into Childhood-Onset Diabetes ◽

10.1007/978-3-319-40242-0_14 ◽

2016 ◽

pp. 163-172

Author(s):

Martin Tauschmann ◽

Roman Hovorka

Keyword(s):

Type 1 Diabetes ◽

Children And Adolescents ◽

Insulin Pump ◽

Glucose Monitoring ◽

Insulin Pump Therapy ◽

Pump Therapy

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Glycemic Outcome Associated With Insulin Pump and Glucose Sensor Use in Children and Adolescents With Type 1 Diabetes. Data From the International Pediatric Registry SWEET

Diabetes Care ◽

10.2337/dc20-1674 ◽

2021 ◽

pp. dc201674

Author(s):

Roque Cardona-Hernandez ◽

Anke Schwandt ◽

Hessa Alkandari ◽

Heiko Bratke ◽

Agata Chobot ◽

...

Keyword(s):

Type 1 Diabetes ◽

Children And Adolescents ◽

Glucose Sensor ◽

Insulin Pump ◽

International Pediatric

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Frequent scanning using flash glucose monitoring contributes to better glycemic control in children and adolescents with type 1 diabetes

Journal of Diabetes Investigation ◽

10.1111/jdi.13618 ◽

2021 ◽

Author(s):

Tatsuhiko Urakami ◽

Kei Yoshida ◽

Remi Kuwabara ◽

Yusuke Mine ◽

Masako Aoki ◽

...

Keyword(s):

Type 1 Diabetes ◽

Glycemic Control ◽

Children And Adolescents ◽

Glucose Monitoring ◽

Flash Glucose Monitoring

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Current status of continuous glucose monitoring among Korean children and adolescents with type 1 diabetes mellitus

Annals of Pediatric Endocrinology & Metabolism ◽

10.6065/apem.2040038.019 ◽

2020 ◽

Vol 25 (3) ◽

pp. 145-151

Author(s):

Jae Hyun Kim

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Children And Adolescents ◽

Continuous Glucose Monitoring ◽

Glucose Monitoring ◽

Current Status ◽

Korean Children

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Screening and Treatment Outcomes in Adults and Children with Type 1 Diabetes and Asymptomatic Celiac Disease: The CD-DIET Study

10.2337/figshare.12041016 ◽

2020 ◽

Author(s):

Farid H. Mahmud ◽

Antoine B.M. Clarke ◽

Kariym C. Joachim ◽

Esther Assor ◽

Charlotte McDonald ◽

...

Keyword(s):

Type 1 Diabetes ◽

Celiac Disease ◽

Glucose Monitoring ◽

Gluten Free ◽

Asymptomatic Patients ◽

Adults And Children ◽

Diet Study ◽

Glycemic Outcomes ◽

Design And Methods

Objective: To describe Celiac Disease (CD) screening rates and glycemic outcomes of a gluten-free diet (GFD) in type 1 diabetes patients asymptomatic for CD. Research Design and Methods: Asymptomatic patients (8-45 years) were screened for CD. Biopsy-confirmed CD participants were randomized to GFD or gluten-containing diet (GCD) to assess changes in HbA1c and continuous glucose monitoring (CGM) over 12 months. Results: Adults had higher CD-seropositivity rates than children (6.8%, 95%CI 4.9% to 8.2%, N=1298 vs. 4.7%; 95%CI 3.4% to 5.9%, N=1089, p=0.035) with lower rates of prior CD-screening (6.9% vs 44.2%, p<0.0001). 51 participants were randomized to a GFD (N=27) or GCD (N=24). No HbA1c differences were seen between groups (+0.14%, 1.5mmol/mol; 95%CI: -0.79 to 1.08; p=0.76) although greater post-prandial glucose increases (4-hr +1.5mmol/L; 95%CI: 0.4 to 2.7; p=0.014) emerged with a GFD. Conclusions: CD is frequently observed in asymptomatic patients with type 1 diabetes and clinical vigilance is warranted with initiation of a GFD.

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