Effectiveness of Continuous Glucose Monitoring Systems with Data Transmission in Children with Type 1 Diabetes: A Three-Year Remote Follow-Up Study
Abstract
Aim
To evaluate the effectiveness of continuous glucose monitoring (CGM) systems with data transmission in children with type 1 diabetes and to assess their impact on key glycemic control parameters.
Materials And Methods
This study included glucose datasets obtained from CGM systems with data transmission in children aged 4–17 years with type 1 diabetes who were connected to a physician’s professional cloud account between September 2021 and November 2024. The effectiveness of CGM use was assessed 1, 2, and 3 years after the initiation of CGM provision. The following parameters were analyzed: sensor activity during the preceding 2 weeks, time in range (TIR) ≥70%, and TIR <50%. Effective CGM use was defined as sensor activity ≥60%.
Results
Among all children with type 1 diabetes, the number of patients provided with CGM systems and connected to the professional cloud account was 716/1713 (41.8%) in year 1, 1339/1838 (72.9%) in year 2, and 1264/1949 (64.9%) in year 3. The proportion of children who used CGM inadequately (sensor activity <60%) did not change significantly over the 3-year period of remote follow-up and was 27.2%, 28.0%, and 26.7%, respectively (p=0.684). Among active CGM users (sensor activity ≥60%), the proportion of children with TIR ≥70% increased significantly by the end of year 3 compared with year 2 and reached 33.1%. The proportion of patients with TIR <50% increased significantly from 27.1% to 38.1% by year 2, then decreased significantly, but remained relatively high by the end of year 3 (30.9%).
Conclusion
Three-year remote follow-up of children with type 1 diabetes provided with CGM systems demonstrated inadequate CGM use in more than one quarter of patients regardless of age. This limited adequate interpretation of glycemic data by the treating physician and adjustment of insulin therapy and may have adversely affected glycemic control in the overall pediatric population with type 1 diabetes. Despite a significant increase in the proportion of active CGM users with TIR ≥70% by the end of year 3, a substantial proportion of children remained at risk of diabetes decompensation (30.9%).