Impact of Continuous Glucose Monitoring on Hemoglobin A1c and Height Trends in Latin American Children with Type 1 Diabetes Onset over 3 Years: A Multicenter Study

Impact of Continuous Glucose Monitoring on Hemoglobin A1c and Height Trends in Latin American Children with Type 1 Diabetes Onset over 3 Years: A Multicenter Study

Objective: To evaluate changes in hemoglobin A1c (HbA1c) levels and z-height over 3 years based on continuous glucose monitoring (CGM) usage among children with new-onset type 1 diabetes (T1DM) from various Latin American centers. Study design: Data on z-height, CGM access, and HbA1c (%) were collec...

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Main Authors: Valeria Hirschler, MD, Claudia Molinari, Msc, Claudio D. Gonzalez, MD, Maria Eugenia Andres, Angela Figueroa Sobrero, Victoria Femenia, Guadalupe Pietropaolo, Maria L. Major, Edit Scaiola, Sandra Mazzetti, Patricia Pasayo, Amanda J. Benitez, Andrea Escalante Marassi, Laura Pardo, Julie Pelicand, Carlos M. Del Aguila Villar, Alejandra Franchello, Ernesto Bogado, Julieta Pomilio, Rosa Flores, Elizabeth Garcia Rusca, Andrea Soledad Reinoso, Analia Morin, Eduardo Rossi, Veronica Vacarezza, Daniela Rodríguez Fuentes, Paula Paz Povedano, Ana L. Garcia, Teresa Martinez, Fabiola Blanco, Oswaldo Núñez Almache, Ana Parada, Patricia Bocco, M Laura Arzamendia, Carla Mannucci, Patricia Taberner, Laura Braguinsky
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Journal of Pediatrics: Clinical Practice
Subjects:
Latin American children
type 1 diabetes
height
CGM
Online Access:http://www.sciencedirect.com/science/article/pii/S295054102400036X
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Summary:Objective: To evaluate changes in hemoglobin A1c (HbA1c) levels and z-height over 3 years based on continuous glucose monitoring (CGM) usage among children with new-onset type 1 diabetes (T1DM) from various Latin American centers. Study design: Data on z-height, CGM access, and HbA1c (%) were collected for Latin American children aged 6 months to 18 years with T1DM onset from 19 centers in a retrospective analysis of medical records, from 2020 to 2023. A 2-way ANOVA method with repeated measures and multiple regression analyses were performed. Results: We included 433 children (46.0% female) aged 8.7 ± 3.7 years; 199 (45.9%) used CGM. The mean HbA1c was significantly lower in years 1, 2, and 3 than at baseline in children with CGM, but not those without CGM. The z-height decreased significantly with the years in both groups. However, the CGM users showed a significantly greater height in years 2 and 3 than the nonusers. Multiple linear regression analysis showed that CGM users exhibited a significantly lower incremental area under the curve (AUC) for HbA1c during follow-up than nonusers. Furthermore, a lower incremental AUC for HbA1c was associated with a smaller decremental AUC for z-height (R2 = 0.19). Multiple logistic regression analysis revealed that children with CGM were 80% more likely (OR, 0.22; 95% CI, 0.1-0.6) to achieve an HbA1c of <7% in the third year of follow-up. Conclusions: This study reveals a significant association between CGM use and lower HbA1c from the onset of T1DM over a 3-year follow-up in Latin American children. Further prospective studies should be performed to confirm this finding.
ISSN:2950-5410

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