Young people with type 1 diabetes who use glucose sensors for continuous glucose monitoring experience fewer acute severe complications. This was shown in a study conducted together with the German Center for Diabetes Research (DZD).
People with diabetes who have well controlled blood sugar levels are less likely to suffer from micro- and macrovascular complications. Although, it is also necessary to prevent acute complications, such as severe hypoglycemia and diabetes ketoacidosis. For young people with type 1 diabetes, it appears that this can be better achieved through continuous glucose monitoring (GCM) via a glucose sensor than conventional blood sugar testing.
In the study, published in Lancet Diabetes & Endocrinology, researchers analyzed the data of more than 32,000 type 1 diabetes patients between the ages of 1.5 and 25 years in Austria, Germany, Luxemburg, and Switzerland. Of these patients, 34% used a glucose sensor for CGM and 66% determined their blood sugar levels themselves using a finger prick test.
“We found that young patients with type 1 diabetes were less likely to develop severe hypoglycemia or diabetic ketoacidosis when using a glucose sensor,” reports Prof. Beate Karges from the Division of Endocrinology and Diabetes at RWTH Aachen University.
Severe Hypoglycemia and Diabetic Ketoacidosis Less Common
Compared to patients using the finger prick test for blood sugar measurement, patients using a glucose sensor were 0.76 times less likely to have severe hypoglycemia and 0.51 times less likely to have diabetic ketoacidosis.
CGM System Provides Data on Risk Parameters
The DZD researchers also investigated whether certain measurement values, provided by the CGM system, were associated with the risk of developing acute complications. They discovered that patients whose glucose levels were below the target value more than 8% of the time were 2.38 times more likely to develop severe hypoglycemia.
Furthermore, when glycemic variability exceeded 36%, severe hypoglycemia was also more common. In contrast, the rate of diabetic ketoacidosis increased when the glucose sensor measured average glucose levels above 180 mg/dl.
CGM Helps Protect Against the Complications of Diabetes
“Our findings show that CGM can help protect young patients with type 1 diabetes from the acute complications of diabetes,” says Karges. “It can also help identify patients who are most at risk of developing such complications, who can then be offered personalized therapy”.
In an editorial, Dr. Alfonso Galderisi and Prof. Jennifer L Sherr, specialists for pediatric endocrinology at Yale University in New Haven, USA, commented that “the findings of this study clearly indicate that this technology helps to reduce the risk of acute diabetic complications”. Through the identification of CGM threshold values, targeted care can be provided to children and adolescents most at risk of developing acute complications.
Original publication:
Karges B, ...., Holl RW. Continuous glucose monitoring versus blood glucose monitoring for risk of severe hypoglycaemia and diabetic ketoacidosis in children, adolescents, and young adults with type 1 diabetes: a population-based study. Lancet Diabetes Endocrinol 2023 Mar 30; https://doi.org/10.1016/S2213-8587(23)00061-X
Editorial:
Galderisi A & Sherr JL. Answering clinically pertinent questions with real-world data from paediatric type 1 diabetes registries. Lancet Diabetes Endocrinol 2023 Mar 30; https://doi.org/10.1016/S2213-8587(23)00085-2