Continuous Glucose Monitoring in Adolescents With Poorly Controlled Type 1 Diabetes

Use of CGM in Adolescents With Poorly-controlled Type 1 Diabetes

The purpose of this study is to see if children and adolescents with poorly controlled type 1 diabetes will benefit from using a continuous glucose monitor (CGM), a device that can be used to check blood sugars.

Adolescents with type 1 diabetes, HbA1c ≥9% on insulin pumps were admitted to the clinical research center and a continuous glucose sensor was inserted. Sensor glucose (SG) values were compared to plasma glucose measured at least hourly using Yellow Springs Instrument's (YSI) glucose analyzer. SG rather than YSI was used for treatment decisions unless YSI was <70 mg/dL or specific criteria indicating SG and YSI were very discordant were met.

Inclusion Criteria:

• 12 to <18 years old
• T1D for at least one year
• Treatment with insulin pump therapy
• A1c ≥9%
• Willingness to comply with study procedures

Exclusion Criteria:

• Current diabetic ketoacidosis
• Hypoglycemia unawareness
• Chronic use of medications that affect recognition of hypoglycemia (e.g., beta blockers)
• Chronic use of medications that mimic symptoms of high or low blood sugars (e.g., decongestants)
• Recent or frequent severe hypoglycemia (2 episodes in the last year; 1 episode in the last 6 months)
• Skin rashes or conditions that may affect CGM placement and wear