Long-term Continuous Glucose Monitor Use in Very Young Children With Type 1 Diabetes: One-Year Results From the SENCE Study

Authors

Michelle A Van Name
Lauren G Kanapka
Linda A DiMeglio
Kellee M Miller
Anastasia Albanese-O'Neill
Persis Commissariat
Sarah D Corathers
Kara R Harrington
Marisa E Hilliard
Barbara J Anderson
Jennifer C Kelley
Lori M Laffel
Sarah A MacLeish
Brandon M Nathan
William V Tamborlane
R Paul Wadwa
Steven M Willi
Kristen M Williams
Kupper A Wintergerst
Stephanie Woerner
Jenise C Wong
Daniel J DeSalvo

Publication Date

7-1-2023

Journal

Journal of Diabetes Science and Technology

DOI

10.1177/19322968221084667

PMID

35343269

PMCID

PMC10348002

PubMedCentral® Posted Date

3-26-2022

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, Child, Child, Preschool, Blood Glucose, Diabetes Mellitus, Type 1, Blood Glucose Self-Monitoring, Hypoglycemia, Hyperglycemia, young children, continuous glucose monitoring, glycemic control, hypoglycemia, behavioral intervention

Abstract

OBJECTIVES: Achieving optimal glycemic outcomes in young children with type 1 diabetes (T1D) is challenging. This study examined the durability of continuous glucose monitoring (CGM) coupled with a family behavioral intervention (FBI) to improve glycemia.

STUDY DESIGN: This one-year study included an initial 26-week randomized controlled trial of CGM with FBI (CGM+FBI) and CGM alone (Standard-CGM) compared with blood glucose monitoring (BGM), followed by a 26-week extension phase wherein the BGM Group received the CGM+FBI (BGM-Crossover) and both original CGM groups continued this technology.

RESULTS: Time in range (70-180 mg/dL) did not improve with CGM use (CGM+FBI: baseline 37%, 52 weeks 41%; Standard-CGM: baseline 41%, 52 weeks 44%; BGM-Crossover: 26 weeks 38%, 52 weeks 40%). All three groups sustained decreases in hypoglycemia (/dL) with CGM use (CGM+FBI: baseline 3.4%, 52 weeks 2.0%; Standard-CGM: baseline 4.1%, 52 weeks 2.1%; BGM-Crossover: 26 weeks 4.5%, 52 weeks 1.7%,

CONCLUSION: Over 12 months young children with T1D using newer CGM technology sustained reductions in hypoglycemia and, in contrast to prior studies, persistently wore CGM. However, pervasive hyperglycemia remained unmitigated. This indicates an urgent need for further advances in diabetes technology, behavioral support, and diabetes management educational approaches to optimize glycemia in young children.