ISSN 1662-4009 (online)

ESPE Yearbook of Paediatric Endocrinology (2021) 18 10.11 | DOI: 10.1530/ey.18.10.11

ESPEYB18 10. Type 1 Diabetes Mellitus (1) (14 abstracts)

10.11. Use of factory-calibrated real-time continuous glucose monitoring improves time in target and HbA1c in a multiethnic cohort of adolescents and young adults with type 1 diabetes: the MILLENNIALS study

Thabit H , Prabhu JN , Mubita W , Fullwood C , Azmi S , Urwin A , Doughty I & Leelarathna L

Diabetes Care. 2020;43(10):2537–2543. doi: 10.2337/dc20-0736.

This paper describes a randomized crossover trial in young people with T1D (16–24 years old) comparing two 8-week study periods: the factory-calibrated Dexcom G6 CGM system versus routine self-monitoring of blood glucose (SMBG). CGM improved time within glucose target and reduced HbA1c by 0.76%.

The primary outcome, time within glucose range 70-180 mg/dL, was higher during CGM than self-monitoring (mean 35.7% vs. 24.6%; mean difference 11.1%). CGM use reduced mean sensor glucose (219.7 mg/dl vs. 251.9 mg/dl; mean difference −32.2 mg/dl) and time above range (61.7% vs. 73.6%; mean difference 11.9%). HbA1c levels were reduced by 0.76%; P < 0.001). Times spent below range (<70 mg/dl and <54 mg/dl) were low and similar during both study periods. Sensor wear was 84% during the CGM period. In is concluded that CGM use in young people with T1D does indeed improve time in glucose target and also HbA1c levels as compared to those with SMBG.

International T1D registries have shown that HbA1c levels in patients with T1D are highest in young adult. Improving their glycemic control remains a challenge. These findings propose the Dexcom G6 CGM system to potentially improve glycemic control in young adults with diabetes.