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Brief Report: Increased technology use associated with lower A1C in a large pediatric clinical population

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posted on 2023-04-06, 19:03 authored by G. Todd Alonso, Taylor M. Triolo, Halis Kaan Akturk, Meghan E. Pauley, Marisa Sobczak, Gregory P. Forlenza, Casey Sakamoto, Laura Pyle, Brigitte I. Frohnert

  

Objective

While continuous glucose monitors (CGM), insulin pumps, and hybrid-closed-loop (HCL) systems each improve glycemic control in type 1 diabetes, it is unclear how use of these technologies impact real-world pediatric care.

Research Design and Methods

Of patients <22 years of age with type 1 diabetes duration >3 months at a single center in 2016-2017 (n=2827) and 2020-2021 (n=2731), 1455 had data in both time periods. Patients were grouped by multiple daily injections (MDI) or insulin pump with or without HCL and using a blood glucose monitor or CGM. Glycemic control was compared using linear mixed effects models adjusting for age, diabetes duration, and race/ethnicity. 

Results
CGM use increased from 32.9% to 75.3%; HCL increased from 0.3% to 27.9%. Overall A1C decreased from 8.9% to 8.6% (p<0.0001). 

Conclusions

Adoption of CGM and HCL was associated with decreased A1C, suggesting promotion of these technologies may yield glycemic benefits.

Funding

NIH/NIDDK 5T32DK063687-17 K12DK094712 P30-DK116073

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