The introduction of new technologies for insulin therapy and glycemic control in clinical practice in the period 2016-2023, and their impact on achieving treatment targets in children with type 1 diabetes mellitus
https://doi.org/10.14341/DM13129
Abstract
BACKGROUND: continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) improve daily life for people with Type 1 Diabetes Mellitus dramatically (T1D). However, there are still no compelling evidences that the use of insulin pumps (IP) and continuous glucose monitors (CGM) really help to improve diabetes control in children and adolescents.
AIM: to analyze the relation between diabetes control and the use of insulin pumps and continuous glucose monitors in children.
MATERIALS AND METHODS: 6382 children with T1D aged 1–18 years were enrolled in this study. Frequency of CSII and CGM use, HbA1с level and the percentage of children with HbA1с< 7.0% were analyzed.
RESULTS: HbA1c decreased from 8.6% to 7.7% for 7 years (p<0.001). Simultaneously the quantity of children with HbA1c<7.0% increased from 11% to 29%. During this period the use of CGM increases dramatically from 11.6% to 84%. The use of IP increases from 38.7% to 42.3% (p<0.001).
CONCLUSION: CSII and continuous glucose monitors use statistically significant improves T1D control in children according to mean HbA1c level decrease and the quantity of children with target HbA1c level increase.
About the Authors
D. N. Laptev
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Dmitry N. Laptev - MD, PhD.; Researcher ID: O-1826-2013; Scopus Author ID: 24341083800.
Moscow
Competing Interests:
none
T. T. Knyazeva
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Tila T. Knyazeva - MD, researcher.
Moscow
Competing Interests:
none
O. B. Bezlepkina
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Olga B. Bezlepkina - MD, PhD, Professor.
Moscow
Competing Interests:
none
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Supplementary files
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1. Figure 1. HbA1c levels by year during the period 2016–2023. Data on the graph are presented as medians. The χ2 test was used to compare HbA1c levels across different years: χ2 = 79, p < 0.001. HbA1c levels are adjusted for age and duration of type 1 diabetes. | |
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2. Figure 2. Distribution of HbA1c levels across various ranges during the period 2016–2023. HbA1c levels are adjusted for age and duration of type 1 diabetes. | |
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3. Figure 3. Proportion of study participants using continuous glucose monitoring (blue bars) and continuous subcutaneous insulin infusion (red bars) during the period 2016–2023. Data are presented as frequencies with 95% confidence intervals. The χ2 test was used to compare the frequencies of CGM and CSII use across different years: CGM: χ2 = 942, p < 0.001; CSII: χ2 = 27, p < 0.001. | |
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4. Figure 4. HbA1c levels (blue bars) and the proportion of participants with HbA1c < 7.0% (green bars) based on the therapy method. Data on the graph are presented as medians. | |
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5. Figure 5. HbA1c levels (blue line and range: median and 25–75th percentiles) and the proportion of patients with HbA1c < 7.0% (green bars) depending on participant age. | |
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For citations:
Laptev D.N., Knyazeva T.T., Bezlepkina O.B. The introduction of new technologies for insulin therapy and glycemic control in clinical practice in the period 2016-2023, and their impact on achieving treatment targets in children with type 1 diabetes mellitus. Diabetes mellitus. 2024;27(5):461-467. (In Russ.) https://doi.org/10.14341/DM13129
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