Impact of Continuous Glucose Monitoring on Hemoglobin A1c and Height Trends in Latin American Children with Type 1 Diabetes Onset over 3 Years: A Multicenter Study

Abstract

ObjectiveTo evaluate changes in HbA1c levels and z-height over three years based on Continuous glucose monitoring (CGM) usage among children with new-onset type 1 diabetes (T1DM) from various Latin American centers. MethodsData on z-height, CGM access, and HbA1c (%) were collected for Latin American children aged six months to 18 years with T1DM onset from 19 centers in a retrospective analysis of medical records, from 2020 to 2023. A two-way ANOVA method with repeated measures and multiple regression analyses were performed. Results433 children (46.0% F) aged 8.7 ± 3.7 years were included, and 199 (45.9%) used CGM. Mean HbA1c was significantly lower in years 1, 2, and 3 than in baseline in children with CGM but not those without CGM. The z-height decreased significantly with the years in both groups. However, the CGM users showed a significantly greater height in years 2 and 3 than the non-users. Multiple linear regression analysis showed that CGM users exhibited a significantly lower incremental area under the curve (AUC) for HbA1c during follow-up than non-users. Furthermore, a lower incremental AUC for HbA1c was associated with a smaller decremental AUC for z-height (R2 = 0.19). Multiple logistic regression analysis revealed that children with CGM were 80% more likely (OR=0.22; 95% CI 0.1-0.6) to achieve an HbA1c < 7% in the third year of follow-up. ConclusionsThis study reveals a significant association between CGM use and lower HbA1c from the onset of T1DM over a three-year follow-up in Latin American children. Further prospective studies should be performed to confirm this finding.