Application of the flash glucose monitoring system in children with type 1 diabetes mellitus

Abstract

Objective To evaluate the usefulness, cost and side effects of flash glucose monitoring (FGM) in children with type 1 diabetes mellitus (T1DM). Methods Seven children aged 9.3-16.3 years old with T1DM (3 males, 4 females) treated with insulin in Shenzhen Children′s Hospital from May 2016 to February 2018 were enrolled, and they were performed with self-monitoring of blood glucose.All participants were subjected to FGM for 4 weeks and compared for changes in terms of hemoglobin A1c (HbA1c), episodes of hypoglycemia and hyperglycemia, frequency of self-monitoring blood glucose(SMBG) or sensor scanning, costs of glucose monitoring and side effects before and after 4-week implementation of FGM. Results The HbA1c was significantly reduced from (8.86±0.32)% before FGM to (8.10±0.14)% after implementation of FGM, and the difference was statistically significant (t=2.727, P=0.034). Both the frequency of hyperglycemia and hypoglycemia were significantly decreased after the implementation of FGM[(0.27±0.04) times/d vs.(0.62±0.05) times/d, (0.20±0.02) times/d vs.(0.37±0.05) times/d], and the differences were statistically significant(t=9.291, 2.908, P=0.001, 0.027). The average frequency of sensor scanning after the implementation of FGM was significantly higher than SMBG testing before use of FGM[(11.09±0.96) times/d vs.(4.02±0.47) times/d], and the difference was statistically significant(t=-24.398, P=0.001). The cost of FGM was a little higher than that of capillary blood glucose testing while there was no significant difference[(814.29±17.71) yuan vs.(758.89±33.42) yuan, P>0.05]. Comparing the results of the FGM and SMBG on the 1st, 7th and 13th day after FGM, there was no significant difference (all P>0.05). Also there was no significant diffe-rence among the different ranges of blood glucose (all P>0.05). The time with sensor of FGM in the arm was (13.9±0.1) days.There was no side effect to be found during 4 weeks of implementation of FGM. Conclusions FGM has the potential to increase the time of SMBG, decrease the hyperglycemia and hypoglycemia, and improve HbA1c in children with T1DM.Accuracy, safety and stability of the FreeStyle Libre System were demonstrated for the pediatric T1DM. Key words: Flash glucose monitoring system; Type 1 diabetes mellitus; Glucose; Therapy; Child