Assessment of metabolic control and use of flash glucose monitoring systems in a cohort of pediatric, adolescents, and adults patients with Type 1 diabetes

Purpose Flash glucose monitoring (FGM) in patients with type 1 diabetes (DM1) provides glucometric data that allow assessing glycemic control beyond HbA1c. The objective of this study was to evaluate metabolic control and use of FGM in a cohort of the pediatric and adult population with DM1. Material and methods A cross-sectional study of patients with DM1 and FGM. Data on the use of the system and metabolic control were evaluated, carrying out a comparative study between different age ranges, <= 12 years; 13-19 years, 20-25 years, and >= 26 years. Results One hundred and ninety-five patients have included: 35.9% children and adolescents (<= 19 years), 42.6% female, 26.2% in treatment with an insulin pump. Mean age was 28.5 +/- 15.9 years, mean duration of diabetes 13.7 +/- 11.0 years, and mean HbA1c 7.1 +/- 0.9% (54 +/- 6 mmol/l). Average daily FGM scans were 11.1 +/- 6.7. Mean glucose was 162 +/- 35 mg/dl, mean standard deviation (SD) 66.1 +/- 20.4 mg/dl, mean coefficient of variation 41.4 +/- 7.9%, mean time in range (TIR) 58.8 +/- 17.0%, mean time above range 33.7 +/- 17.6% and mean time below range 7.5 +/- 5.8%. The pediatric group showed higher TIR, lower HbA1c, lower glycemic variability, lower mean glucose, and higher use of the device than the adult population. In the entire cohort, the device scans showed a negative quadratic correlation with HbA1c, mean glucose, SD, and age and a positive quadratic correlation with TIR. Conclusions Children under 12 years showed the best metabolic control and the most frequent use of the device. Metabolic control deteriorates with age. The greater number of device scans was in correlation with better metabolic control in all age groups.