Feasibility of prolonged continuous glucose monitoring in toddlers with type 1 diabetes

Objective To examine the feasibility of continuous glucose monitoring (CGM) use in very young children with type 1 diabetes (T1D). Research design and methods Twenty-three children less than 4 yr of age with T1D were provided with a FreeStyle Navigator (R) (n similar to=similar to 21) or a Paradigm (R) (n similar to=similar to 2) CGM device. At baseline, mean age was 3.0 similar to +/-similar to 0.8 yr, mean hemoglobin A1c (HbA1c) was 8.0 +/- 0.8%, 10 were using an insulin pump and 13 were on multiple daily injections. CGM use was evaluated over a 6-month period. Results Three children dropped out of the study before the end of 6 months. Among the 20 children who completed 6 months of follow-up, CGM use in month 6 was =6 d/wk in 9 (45%), 4 similar to=similar to 6 d/wk in 2 (10%), and <4 d/wk in 9 (45%). Skin reactions were minimal. Although there was no detectable change in mean HbA1c between baseline and 6 months (7.9 and 8.0%, respectively), there was a high degree of parental satisfaction with CGM as measured on the CGM satisfaction scale questionnaire. A high percentage of glucose values were in the hyperglycemic range, and biochemical hypoglycemia was infrequent. Conclusion More than 40% of very young children were able to safely use CGM on a near-daily basis after 6 months. CGM demonstrated frequent hyperglycemic excursions, with a large variability in glucose readings. Although improvement in glycemic control was not detected in the group as a whole, parental satisfaction with CGM was high.