Increased Technology Use Associated With Lower A1C in a Large Pediatric Clinical Population

• Published in: Diabetes care Vol. 46; no. 6; pp. 1218 - 1222
• Main Authors: Alonso, G Todd, Triolo, Taylor M, Akturk, Halis Kaan, Pauley, Meghan E, Sobczak, Marisa, Forlenza, Gregory P, Sakamoto, Casey, Pyle, Laura, Frohnert, Brigitte I
• Format: Journal Article
• Language: English
• Published: United States American Diabetes Association 01-06-2023
• Subjects: Blood Glucose; Blood Glucose Self-Monitoring; Child; Closed loops; Diabetes; Diabetes mellitus; Diabetes mellitus (insulin dependent); Diabetes Mellitus, Type 1; Ethnicity; Glucose; Glycated Hemoglobin; Humans; Hybrid systems; Hypoglycemic Agents; Insulin; Insulin Infusion Systems; Insulins; Minority & ethnic groups; Patients; Pediatrics; Research design; Technology
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/dc22-2121

While continuous glucose monitors (CGMs), insulin pumps, and hybrid closed-loop (HCL) systems each improve glycemic control in type 1 diabetes, it is unclear how the use of these technologies impacts real-world pediatric care.
We found 1,455 patients aged <22 years, with type 1 diabetes duration >3 months, and who had data from a single center in between both 2016-2017 (n = 2,827) and 2020-2021 (n = 2,731). Patients were grouped by multiple daily injections or insulin pump, with or without an HCL system, and using a blood glucose monitor or CGM. Glycemic control was compared using linear mixed-effects models adjusting for age, diabetes duration, and race/ethnicity.
CGM use increased from 32.9 to 75.3%, and HCL use increased from 0.3 to 27.9%. Overall A1C decreased from 8.9 to 8.6% (P < 0.0001).
Adoption of CGM and HCL was associated with decreased A1C, suggesting promotion of these technologies may yield glycemic benefits.