Santova Alzbeta, Neuman Vit, Plachy Lukas, Amaratunga Shenali Anne, Pavlikova Marketa, Romanova Martina, Konecna Petra, Neumann David, Kocourkova Kamila, Strnadel Jiri, Pomahacova Renata, Venhacova Petra, Skvor Jaroslav, Obermannova Barbora, Pruhova Stepanka, Cinek Ondrej, Šumník Zdeněk
Department of Pediatrics, Motol University Hospital and 2nd Faculty of Medicine, Prague, Czechia.
1st Faculty of Medicine, Charles University, Prague, Czechia.
Diabetes Technol Ther. 2025 Apr;27(4):301-307. doi: 10.1089/dia.2024.0472. Epub 2025 Jan 6.
The recommended threshold for the time spent on continuous glucose monitoring (CGM) is established at 70%. However, glucose outcomes in children with type 1 diabetes (CwD) using CGM for a different proportion of time within this threshold have not been evaluated yet. The study aims to compare glycemic parameters among CwD who spent 70%-89% and ≥90% on CGM using the population-wide data from the Czech national pediatric diabetes registry ČENDA. CwD aged <19 years who used real-time CGM >70% of the time and did not change the type of therapy throughout the year 2023 were included and divided into two groups based on the time they spent on CGM-70%-89% versus ≥90%. HbA1c, times in standard glycemic ranges, mean glucose, and coefficient of variability (CV) were compared between the groups and by treatment modalities. Data from 1977 CwD (1035 males and 942 females) were evaluated. Among them, 404 participants (20.4%) used CGM 70%-89% of the time, and 1573 participants (79.6%) ≥90% of the time. Compared with the 70-89% group, the ≥90% CGM users achieved significantly lower HbA1c levels (51 mmol/mol, 6.8% vs. 58 mmol/mol, 7.4%, < 0.001), higher time in range (72% vs. 60%, < 0.001), and lower mean glucose and CV (8.1 mmol/L, 146 mg/dL vs. 9.1 mmol/L, 164 mg/dL and 37% vs. 40%, respectively, both < 0.001). Analogous results were seen irrespective of the treatment modality. The differences persisted after propensity score adjustment. CGM use for ≥90% is associated with tighter glycemic control compared with 70%-89% use. Therefore, it is essential to motivate CwD to use CGM for the longest possible time and search for suitable options to overcome barriers in uninterrupted CGM monitoring.
连续血糖监测（CGM）的推荐使用时长阈值设定为70%。然而，1型糖尿病患儿（CwD）在该阈值范围内不同时长使用CGM的血糖结果尚未得到评估。本研究旨在利用捷克国家儿童糖尿病登记处ČENDA的全人群数据，比较CGM使用时长为70%-89%和≥90%的CwD的血糖参数。纳入了2023年全年实时CGM使用时长>70%且未改变治疗类型的<19岁CwD，并根据其CGM使用时长分为两组——70%-89%组和≥90%组。比较了两组之间以及不同治疗方式下的糖化血红蛋白（HbA1c）、处于标准血糖范围的时长、平均血糖和变异系数（CV）。对1977名CwD（1035名男性和942名女性）的数据进行了评估。其中，404名参与者（20.4%）CGM使用时长为70%-89%，1573名参与者（79.6%）CGM使用时长≥90%。与70-89%组相比，CGM使用时长≥90%的使用者糖化血红蛋白水平显著更低（51 mmol/mol，6.8% 对比 58 mmol/mol，7.4%，<0.001），处于血糖范围的时长更高（72% 对比 60%，<0.001），平均血糖和变异系数更低（分别为8.1 mmol/L，146 mg/dL 对比 9.1 mmol/L，164 mg/dL以及37% 对比 40%，均<0.001）。无论治疗方式如何，均观察到类似结果。倾向得分调整后差异依然存在。与70%-89%的使用时长相比，CGM使用时长≥90%与更严格的血糖控制相关。因此，激励CwD尽可能长时间使用CGM并寻找合适方法克服连续CGM监测中的障碍至关重要。
