Use of continuous glucose monitoring and its association with type 1 diabetes control in children over the first 3 years of reimbursement approval: Population data from the ČENDA registry.


Journal

Pediatric diabetes
ISSN: 1399-5448
Titre abrégé: Pediatr Diabetes
Pays: Denmark
ID NLM: 100939345

Informations de publication

Date de publication:
05 2021
Historique:
revised: 12 01 2021
received: 25 10 2020
accepted: 18 01 2021
pubmed: 4 2 2021
medline: 18 1 2022
entrez: 3 2 2021
Statut: ppublish

Résumé

Increased access to modern technologies is not always accompanied by a decrease in HbA1c. The aim of this study was to identify changes in the proportion of continuous glucose monitoring (CGM) users since 2017, when general reimbursement for CGM became effective in Czechia, and to test whether HbA1c is associated with the percentage of time spent on CGM. All T1D children in the Czech national ČENDA registry (3197 children) were categorized according to their time spent on CGM and associations with age, sex, center size, and HbA1c were tested with calendar year as a stratification factor. The proportion of children with any CGM use increased from 37.9% in 2017 to 50.3% in 2018 and 74.8% in 2019. Of the CGM users, 16%, 28%, and 41% of the children spent >70% of their time on CGM over the 3 years of the study period, with an overrepresentation of children in the <10 years age group versus the older age groups (p < 0.001). The proportion of CGM users differed among centers and was positively associated with a large center size (>100 patients) (p < 0.001). HbA1c was negatively associated with the time spent on CGM (p < 0.001). A rapid increase in CGM use was reported over the 3 years after general reimbursement. HbA1c was associated with time spent on CGM, a continuing decrease was observed in the >70% category. Reimbursement for CGM likely contributes to the improvement of T1D control at the population level.

Identifiants

pubmed: 33533545
doi: 10.1111/pedi.13184
doi:

Substances chimiques

Glycated Hemoglobin A 0
Hypoglycemic Agents 0
Insulin 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

439-447

Informations de copyright

© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Références

Tauschmann M, Hovorka R. Technology in the management of type 1 diabetes mellitus - current status and future prospects. Nat Rev Endocrinol. 2018;14:464-475.
van den Boom L, Karges B, Auzanneau M, et al. Temporal trends and contemporary use of insulin pump therapy and glucose monitoring among children, adolescents, and adults with type 1 diabetes between 1995 and 2017. Diabetes Care. 2019;42:2050-2056.
Miller KM, Hermann J, Foster N, et al. Longitudinal changes in continuous glucose monitoring use among individuals with type 1 diabetes: international comparison in the German and Austrian DPV and U.S. T1D exchange registries. Diabetes Care. 2020;43:1-2.
Šoupal J, Petruželková L, Grunberger G, et al. Glycemic outcomes in adults with T1D are impacted more by continuous glucose monitoring than by insulin delivery method: 3 years of follow-up from the COMISAIR study. Diabetes Care. 2020;43:37-43.
Battelino T, Conget I, Olsen B, et al. The use and efficacy of continuous glucose monitoring in type 1 diabetes treated with insulin pump therapy: a randomised controlled trial. Diabetologia. 2012;55:3155-3162.
DeSalvo DJ, Miller KM, Hermann JM, et al. Continuous glucose monitoring and glycemic control among youth with type 1 diabetes: international comparison from the T1D exchange and DPV initiative. Pediatr Diabetes. 2018;19:1271-1275.
Clements MA, Schwandt A, Donaghue KC, et al. Five heterogeneous HbA1c trajectories from childhood to adulthood in youth with type 1 diabetes from three different continents: a group-based modeling approach. Pediatr Diabetes. 2019;20:920-931.
Sumnik Z, Szypowska A, Iotova V, et al. Persistent heterogeneity in diabetes technology reimbursement for children with type 1 diabetes: the SWEET perspective. Pediatr Diabetes. 2019;20:434-443.
Šumník Z, Venháčová J, Škvor J, et al. Five years of improving diabetes control in Czech children after the establishment of the population-based childhood diabetes register ČENDA. Pediatr Diabetes. 2020;21:77-87.
Cinek O, Kulich M, Sumnik Z. The incidence of type 1 diabetes in young Czech children stopped rising. Pediatr Diabetes. 2012;13:559-563.
American Diabetes Association; European Association for the Study of Diabetes; International Federation of Clinical Chemistry and Laboratory Medicine; International Diabetes Federation. Consensus statement on the worldwide standardisation of the HbA1c measurement. Diabetologia. 2007;50:2042-2043.
Mastrototaro J. The MiniMed continuous glucose monitoring system (CGMS). J Pediatr Endocrinol Metab. 1999;12(3):751-758.
Westen SC, Warnick JL, Albanese-O'Neill A, et al. Objectively measured adherence in adolescents with type 1 diabetes on multiple daily injections and insulin pump therapy. J Pediatr Psychol. 2019;44:21-31.
Szypowska A, Schwandt A, Svensson J, et al. Insulin pump therapy in children with type 1 diabetes: analysis of data from the SWEET registry. Pediatr Diabetes. 2016;17(23):38-45.
Hásková A, Radovnická L, Petruželková L, et al. Real-time CGM is superior to flash glucose monitoring for glucose control in type 1 diabetes: the CORRIDA randomized controlled trial. Diabetes Care. 2020;43:2744-2750.
Birkebaek N, Hermann J, Hanberger L, et al. Centre size and glycemic control: an international study with 504 centers from seven countries. Diabetes Care. 2019;42:37-39.
Sandig D, Grimsmann J, Reinauer C, et al. Continuous glucose monitoring in adults with type 1 diabetes: real-world data from the German/Austrian prospective diabetes follow-up registry. Diabetes Technol Ther. 2020;22:602-612.
Battelino T, Danne T, Bergenstal RM, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Diabetes Care. 2019;42:1593-1603.
Sherr JL, Tauschmann M, Battelino T, et al. ISPAD clinical practice consensus guidelines 2018: diabetes technologies. Pediatr Diabetes. 2018;19(27):302-325.
Szypowska A, Ramotowska A, Dzygalo K, Golicki D. Beneficial effect of real-time continuous glucose monitoring system on glycemic control in type 1 diabetic patients: systematic review and meta-analysis of randomized trials. Eur J Endocrinol. 2012;166:567-574.

Auteurs

Zdeněk Šumník (Z)

Department of Pediatrics, Motol University Hospital and Charles University, 2nd Faculty of Medicine, Prague, Czech Republic.

Markéta Pavlíková (M)

Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics, Charles University, Prague, Czech Republic.

Renata Pomahačová (R)

Department of Pediatrics, University Hospital Pilsen, Pilsen, Czech Republic.

Petra Venháčová (P)

Department of Pediatrics, University Hospital Olomouc, Olomouc, Czech Republic.

Lenka Petruželková (L)

Department of Pediatrics, Motol University Hospital and Charles University, 2nd Faculty of Medicine, Prague, Czech Republic.

Jaroslav Škvor (J)

Department of Pediatrics, Masaryk Hospital, Ústí nad Labem, Czech Republic.

David Neumann (D)

Department of Pediatrics, University Hospital, Hradec Králové, Czech Republic.

Jan Vosáhlo (J)

Department of Pediatrics, 3rd Faculty of Medicine, Prague, Czech Republic.

Petra Konečná (P)

Department of Pediatrics, University Hospital Brno, Brno, Czech Republic.

Jindřich Čížek (J)

Department of Pediatrics, Hospital České Budějovice, České Budějovice, Czech Republic.

Jiří Strnadel (J)

Department of Pediatrics, University Hospital Ostrava, Ostrava, Czech Republic.

Štěpánka Průhová (Š)

Department of Pediatrics, Motol University Hospital and Charles University, 2nd Faculty of Medicine, Prague, Czech Republic.

Ondřej Cinek (O)

Department of Pediatrics, Motol University Hospital and Charles University, 2nd Faculty of Medicine, Prague, Czech Republic.

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