Comparative Effectiveness of Continuous Versus Conventional Glucose Monitoring for Early Diabetes Risk Detection in Children with Acanthosis Nigricans

INTRODUCTION: The rising incidence of pediatric diabetes underscores the need for accurate glucose monitoring tools to facilitate early detection. Although both Blood Glucose Meters (BGM) and Continuous Glucose Monitoring (CGM) are widely used, their comparative effectiveness in predicting diabetes onset in children remains contested. This study evaluated and compared the predictive utility of BGM and CGM in high-risk pediatric populations. METHODS: A nine-month prospective observational study (January–September 2024) was conducted at the Health Polytechnic of the Ministry of Health, Sorong, involving 76 children aged 10–18 years diagnosed with Acanthosis Nigricans and positive FINDRISC scores. Participants were allocated to either BGM (every 3 days) or CGM (15-minute intervals). Key outcome measures included Time in Range (TIR), mean glucose levels, frequencies of hypo- and hyperglycaemic episodes, adherence rates, and Mean Absolute Relative Difference (MARD). RESULTS: CGM significantly outperformed BGM across all parameters: higher TIR (78.9% vs. 63.4%, p<0.001), lower average glucose levels (145.3 vs. 162.7 mg/dL, p=0.003), fewer hypoglycaemic (1.1 vs. 2.8, p=0.015) and hyperglycaemic events (2.6 vs. 4.5, p=0.002), and superior adherence (88.7% vs. 71.3%, p<0.001). CGM also showed a lower MARD (7.2% vs. 10.8%, p=0.004), indicating greater accuracy. CONCLUSIONS: CGM offers more reliable and comprehensive glucose monitoring than BGM for predicting diabetes onset in children at risk, supported by better glycaemic control, higher adherence, and improved accuracy. These findings endorse CGM as the preferred approach for early diabetes detection in pediatric populations.