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Title: | Effect of nationwide reimbursement of real-time continuous glucose monitoring on HbA1c, hypoglycemia and quality of life in a pediatric type 1 diabetes population: The RESCUE-pediatrics study | Authors: | De Ridder, Francesca Charleer, Sara Jacobs , Seppe Bolsens, Nancy Ledeganck, Kristien J. Van Aken, Sara Vanbesien, Jesse Gies, Inge Casteels, Kristina MASSA, Guy Lysy, Philippe A. Logghe, Karl Lebrethon, Marie-Christine Depoorter, Sylvia Gillard, Pieter De Block, Christophe den Brinker, Marieke RESCUE Trial Investigators |
Issue Date: | 2022 | Publisher: | FRONTIERS MEDIA SA | Source: | Frontiers in Pediatrics, 10 (Art N° 991633) | Abstract: | Objective: Real-time continuous glucose monitoring (RT-CGM) can improve metabolic control and quality of life (QoL), but long-term real-world data in children with type 1 diabetes (T1D) are scarce. Over a period of 24 months, we assessed the impact of RT-CGM reimbursement on glycemic control and QoL in children/adolescents with T1D treated with insulin pumps. Research design and methods: We conducted a multicenter prospective observational study. Primary endpoint was the change in HbA1c. Secondary endpoints included change in time in hypoglycemia, QoL, hospitalizations for hypoglycemia and/or ketoacidosis and absenteeism (school for children, work for parents). Results: Between December 2014 and February 2019, 75 children/adolescents were followed for 12 (n = 62) and 24 months (n = 50). Baseline HbA1c was 7.2 +/- 0.7% (55 +/- 8mmol/mol) compared to 7.1 +/- 0.8% (54 +/- 9mmol/mol) at 24 months (p = 1.0). Participants with a baseline HbA1c >= 7.5% (n = 27, mean 8.0 +/- 0.3%; 64 +/- 3mmol/mol) showed an improvement at 4 months (7.6 +/- 0.7%; 60 +/- 8mmol/mol; p = 0.009) and at 8 months (7.5 +/- 0.6%; 58 +/- 7mmol/mol; p = 0.006), but not anymore thereafter (endpoint 24 months: 7.7 +/- 0.9%; 61 +/- 10mmol/mol; p = 0.2). Time in hypoglycemia did not change over time. QoL for parents and children remained stable. Need for assistance by ambulance due to hypoglycemia reduced from 8 to zero times per 100 patient-years (p = 0.02) and work absenteeism for parents decreased from 411 to 214 days per 100 patient-years (p = 0.03), after 24 months. Conclusion: RT-CGM in pump-treated children/adolescents with T1D showed a temporary improvement in HbA1c in participants with a baseline HbA1c & GE; 7.5%, without increasing time in hypoglycemia. QoL was not affected. Importantly, RT-CGM reduced the need for assistance by ambulance due to hypoglycemia and reduced work absenteeism for parents after 24 months. | Notes: | den Brinker, M (corresponding author), Univ Antwerp, Fac Med & Hlth Sci, Lab Expt Med & Pediat LEMP, Antwerp, Belgium.; den Brinker, M (corresponding author), Antwerp Univ Hosp UZA, Dept Pediat, Antwerp, Belgium. marieke.denbrinker@uza.be |
Keywords: | type 1 diabetes;real-time continuous glucose monitoring (RT-CGM);HbA1c;hypoglycemia;quality of life;time in range | Document URI: | http://hdl.handle.net/1942/38896 | ISSN: | 2296-2360 | e-ISSN: | 2296-2360 | DOI: | 10.3389/fped.2022.991633 | ISI #: | 000875514900001 | Rights: | 2022 De Ridder, Charleer, Jacobs, Bolsens, Ledeganck, Van Aken, Vanbesien, Gies, Casteels, Massa, Lysy, Logghe, Lebrethon, Depoorter, Gillard, De Block and den Brinker. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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Effect of nationwide reimbursement of real-time continuous glucose monitoring on HbA1c, hypoglycemia and quality of life in a pediatric type 1 diabetes population_ The RESCUE-Pediatrics study.pdf | Published version | 2.19 MB | Adobe PDF | View/Open |
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