Application of flash glucose monitoring system in children with type 1 diabetes mellitus

Objective To investigate the status of blood glucose control in children with type 1 diabetes mellitus (T1DM) in Henan Province, and the safety of flash glucose monitoring system (FGMS) in children with T1DM. Methods Between August 2017 and February 2018, 116 children with TIDM from the Department of Endocrinology in 15 hospitals were selected, including the First Affiliated Hospital of Henan University of Science and Technology and other tertiary hospitals in Henan province. All patients were younger than 14 years old and treated with either continuous subcutaneous insulin infusion (CSII) or multiple daily insulin injection (MDI). All patients wore FGMS for 2 weeks after the selection. Various glucose monitoring indicators and adverse events were recorded during the application of FGMS, and the effects of diabetes duration, insulin injection model and other factors on blood glucose control were also analyzed. The t test, analysis of variance and rank sum test were used to compare the differences between groups, the correlation was analyzed by partial correlation. Results The baseline glycated hemoglobin A1c (HbA1c) was (8.3±1.7)%. During the application of FCMS, the estimated HbA1c was (7.8±1.3)%, the mean blood glucose was (9.8±2.1) mmol/L, and the percentage of time of blood glucose reaching the target (3.9-7.8 mmol/L) was (37±14)%. The percentage of time of hypoglycemia (<3.9 mmol/L) was 4% (3, 8)%. The standard deviation of blood glucose (SDBG) was (4.1±1.2) mmol/L and the mean amplitude of glycemic excursion (MAGE) was (8.4±2.5) mmol/L. The SDBG and MAGE in CSII group were decreased compared with MDI group (t=2.65, 2.51, both P<0.05). The partial correlation analysis showed that the SDBG as well as the MAGE was positively correlated with the baseline HbA1c (r=0.401, 0.357, both P<0.05). No adverse events related to FGMS was recorded during the study period. The drop rate of FGMS sensors was decreased significantly in winter. Conclusion T1DM patients under 14 years old in Henan province have a high HbA1c level, a high risk of hypoglycemia and a large fluctuation of blood glucose. The application of FGMS in children is safe. It may be helpful to reduce the drop of the sensor by avoiding the exposure of FGMS sensors.