1042 Does the use of technology improve glycosylated haemoglobin levels in children with type 1 diabetes mellitus (T1DM)?

Published Date: 11th October 2021

Publication Authors: Yasso K

Background
The 2017/18 National Paediatric Diabetes Audit (NPDA) in the U.K. reported that on average, insulin pump users with continuous glucose monitors achieved lower HbA1c levels compared to manual glucose checks.

Objectives
This study involves children and young people (CYP) aged below 19 years with Type 1 Diabetes Mellitus (T1DM) attending a tertiary UK hospital. The aim was to compare median HbA1c outcomes by grouping patients according to their insulin regimens and glucose monitoring devices.

Methods
This was a retrospective observational study using our hospital diabetes database to identify patients. Inclusion criteria were T1DM patients on multiple dose insulin (MDI) or insulin pump regimens. 405 patients were categorised by their insulin regimen and the type of glucose monitoring device in use, which included: manual checks, Dexcom G6, Libre Flash, insulin pumps with Low Glucose Suspend (LGS) and Closed Loop Systems (CLS). The median HbA1c was calculated for each group and analysed.

Results
Of the 405 patients included, 187 (46%) used continuous subcutaneous insulin infusions (CSII) and 218 (54%) used multiple daily injections (MDI) regimens. Table 1 demonstrates the median HbA1c for each group of patients.

The lowest median HbA1c was in the pump group using a closed loop system, while those on MDI, even with Libre Flash, struggled with higher HbA1cs.

Dexcom G6 and Libre Flash users in the pump patient group had similar median hba1c levels.

Conclusions
As per the published studies, this work supports the use of advanced technology in diabetes care and of closed loop systems to provide the best possible glycaemic control. Interestingly, despite Dexcom G6 being more expensive than Libre Flash, this small study has not shown any advantage for the use of Dexcom G6 in terms of diabetes control for CYP on insulin pumps.

Yasso, K et al. (2021). 1042 Does the use of technology improve glycosylated haemoglobin levels in children with type 1 diabetes mellitus (T1DM)?. Archives of Disease in Childhood. 106 (Suppl 1), A204

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