medwireNews: Using Continuous Glucose Monitoring (CGM) within the first month of diagnosis has been linked to improved glycemic control in adolescents with type 1 diabetes, results from the 4T study show.
At the ADA’s 81st virtual scientific sessions, Priya Prahalad (Stanford University, Palo Alto, California, USA) stated that children and adolescents with type 1 diabetes typically start using diabetes technology “months to years” after diagnosis use, and researchers found earlier use would be associated with better results.
In the 4T study (Teamwork, Targets, Technology and Tight Control), 136 participants who were diagnosed with type 1 diabetes in the period 2018-2020, a median of 9.6 years, started with CGM in the first month after diagnosis, with a median time to induction of 7 days. The researchers compared the trajectories of glycated hemoglobin (HbA1c) in these individuals with the trajectories in a historical cohort of 272 people averaging 9.7 years of age who were diagnosed in 2014-2016 and who initiated CGM after an average of 221 days.
Prahalad reported that in both the 4T cohort and the historical control cohort, mean HbA1c levels were highest at diagnosis and lowest after about 3 months, with a gradual increase thereafter. The HbA1c value decreased similarly between the baseline and the 3-month follow-up in both groups, from 11.48% to 6.92% (102–52 mmol / mol) and 10.24% to 6, respectively , 75% (88-50 mmol / mol) mol.
At the follow-up examination after 6 months, however, the average HbA1c values in the 4T group were about 0.5 percentage points lower than in the historical cohort, at 6.77% compared to 7.29% (50 vs 56 mmol / mol), and this difference remained at 7.42% versus 7.94% (58 versus 63 mmol / mol) at the 12-month follow-up.
In agreement with these results, the proportion of people with HbA1c values below 7.5% (58 mmol / mol) was higher among the participants in the 4T study than in the historical cohort after 6 months (70 vs. 66%), 9 – Month (65 vs. 53%), 12-month (57 vs. 45%) and 15-month (60 vs. 38%) follow-up examinations.
Prahalad noted that participants in the 4T study diagnosed between March 2019 and May 2020 were offered weekly remote monitoring with a CGM care team, and an additional study presented as a poster compared glycemic results at the patients who accepted the offer with those who received CGM alone.
In this study, Prahalad and colleagues found that the 89 participants who underwent CGM with remote monitoring had lower mean HbA1c levels than the 47 CGM at 6-month follow-up alone, at 6.69% versus 6 , 88% (50 vs 52 mmol / mol.). ), and this difference was maintained at 7.32% vs. 7.56% (57 vs. 59 mmol / mol) after 12 months.
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Scientific meetings of the ADA; 25-29 June 2021 (excerpt 69-OR)
Scientific meetings of the ADA; 25-29 June 2021 (extract 916-P)
