Association between Continuous Glucose Monitoring and Risk of Acute Diabetes-Related Complications in Pediatric Type 1 Diabetes Mellitus: A Nationwide Cohort Study.
Evidence supporting the benefits of continuous glucose monitoring (CGM) in reducing diabetes-related complications remains scarce. This study aimed to investigate the association between CGM and diabetes-related complications, specifically diabetic ketoacidosis (DKA) and severe hypoglycemia in children and adolescents with type 1 diabetes mellitus (T1DM).
From the Korean Nationwide Cohort (2016-2022), we included children and adolescents (aged <19 years) with T1DM who received rapid-acting insulin between 2019 and 2022. The primary outcomes were DKA and severe hypoglycemia. Adjusted hazard ratios (HRs) for the primary outcomes were compared between CGM users and non-users using Cox proportional hazards regression models. Additionally, among the CGM users, the frequencies of DKA and severe hypoglycemia were compared before and after CGM initiation using a paired t-test.
This study included 3,765 children and adolescents (2,313 CGM users and 1,452 non-users). During a median follow-up of 2.7 years, CGM users showed a lower risk of DKA (adjusted HR, 0.44; 95% confidence interval [CI], 0.35 to 0.56) and severe hypoglycemia (adjusted HR, 0.48; 95% CI, 0.29 to 0.79) than non-users. Among CGM users, the mean frequency of DKA decreased by 64%, and that of severe hypoglycemia decreased by 57% after CGM initiation (P<0.001 for both).
In this nationwide cohort study, CGM was associated with a reduced risk of DKA and severe hypoglycemia in children and adolescents with T1DM.
From the Korean Nationwide Cohort (2016-2022), we included children and adolescents (aged <19 years) with T1DM who received rapid-acting insulin between 2019 and 2022. The primary outcomes were DKA and severe hypoglycemia. Adjusted hazard ratios (HRs) for the primary outcomes were compared between CGM users and non-users using Cox proportional hazards regression models. Additionally, among the CGM users, the frequencies of DKA and severe hypoglycemia were compared before and after CGM initiation using a paired t-test.
This study included 3,765 children and adolescents (2,313 CGM users and 1,452 non-users). During a median follow-up of 2.7 years, CGM users showed a lower risk of DKA (adjusted HR, 0.44; 95% confidence interval [CI], 0.35 to 0.56) and severe hypoglycemia (adjusted HR, 0.48; 95% CI, 0.29 to 0.79) than non-users. Among CGM users, the mean frequency of DKA decreased by 64%, and that of severe hypoglycemia decreased by 57% after CGM initiation (P<0.001 for both).
In this nationwide cohort study, CGM was associated with a reduced risk of DKA and severe hypoglycemia in children and adolescents with T1DM.