1295-P: Newly Diagnosed Pediatric Patients with Type 1 Diabetes Show Steady Decline in Glucose Time-in-Range (TIR) over 1 Year: Pilot Study

Abstract

Optimal glycemic control is associated with improved T1D outcomes. However, in the U.S. over the last decade, glycemic control has worsened. We aimed to monitor glucose time-in-range (TIR) in the first year after diagnosis in pediatric T1D to identify the time when glucose control worsens. Newly diagnosed patients (N=67) with T1D were commenced on continuous glucose monitoring (CGM). Data was uploaded to Dexcom Clarity and analyzed retrospectively. Sample size differences at each time period vary due to patient enrollment start dates. All data was analyzed by mixed model and Tukey’s multiple comparison test. In 67 children (mean age 10±5 yrs, A1c at onset 12.1±1.9%) glucose TIR decreased from 64±21% to 55±18% at 10±9 days to 361±23 days post-diagnosis (P=0.03, Table). Mean glucose increased from 146±28 mg/dL at nadir to 172±29 mg/dL at 361±23 days post-diagnosis (P=0.001). CGM wear time also increased from 83±20% to 95±9% at 10±9 days to 361±23 days post-diagnosis (P=0.04). Time spent <70 mg/dL was 2±3% throughout. Newly diagnosed pediatric T1D patients continue to wear CGM throughout the first year of diagnosis. The apparent increase in mean CGM glucose and decrease in TIR as early as 205±9 days post-diagnosis presents an opportunity for more frequent monitoring and unified education by healthcare providers to target tighter glucose control for this population. Disclosure D. Zaharieva: Speaker’s Bureau; Self; Ascensia Diabetes Care, Insulet Corporation, Medtronic. P. Prahalad: None. A. Addala: None. D. Scheinker: None. M. Desai: None. K.K. Hood: Research Support; Self; Dexcom, Inc. Speaker’s Bureau; Self; LifeScan, Inc., MedIQ. B. Leverenz: None. D.M. Maahs: Advisory Panel; Self; Eli Lilly and Company, Insulet Corporation, Medtronic, Novo Nordisk A/S. Consultant; Self; Abbott, Sanofi. Research Support; Self; Bigfoot Biomedical, Dexcom, Inc., Roche Diabetes Care, Tandem Diabetes Care.