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

Diabetes Care. 2023 Jun 1;46(6):1218-1222. doi: 10.2337/dc22-2121.

Abstract

Objective: 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.

Research design and methods: 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.

Results: 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).

Conclusions: Adoption of CGM and HCL was associated with decreased A1C, suggesting promotion of these technologies may yield glycemic benefits.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose
  • Blood Glucose Self-Monitoring
  • Child
  • Diabetes Mellitus, Type 1*
  • Ethnicity
  • Glycated Hemoglobin
  • Humans
  • Hypoglycemic Agents
  • Insulin
  • Insulin Infusion Systems
  • Insulins*
  • Technology

Substances

  • Glycated Hemoglobin
  • Insulins
  • Blood Glucose
  • Insulin
  • Hypoglycemic Agents