Continuous Glucose Monitoring Improves Glycemic Outcomes in Children With Type 1 Diabetes: Real-world Data From a Population-Based Clinic

Although recent clinical trials of continuous glucose monitoring (CGM) use have shown positive glycemic benefit (1,2), outcomes outside the research setting may differ and real-world studies over a long time period are limited. In April 2017, CGM was fully subsidized in Australia for people living with type 1 diabetes (T1D) <21 years. Perth Children’s Hospital is the sole pediatric diabetes center in Western Australia and is where almost all patients <18 years of age are seen (1,192 patients in 2019). This provided unique opportunity to determine the glycemic outcomes in a state-wide population-based pediatric cohort before and after commencement of CGM in a real-world setting. The aim of this study was to investigate impact on glycemic control with commencement of subsidized CGM. An observational longitudinal study of Western Australian children with T1D attending Perth Children’s Hospital between January 2015 and July 2019 was performed, with the following inclusion criteria: age 2 years, and at least 2 pre– and post–CGM clinic visits. Participants were using Dexcom or Medtronic CGM available through subsidy. The primary outcome was HbA1c measured at 3-monthly clinic visits. Values up to 3 years pre– and up to 2 years post–CGM commencement were included. A multilevel piecewise growth modeling approach with maximum likelihood estimation was used for …