Sleep Quality in Caregivers of Pediatric Patients with Type 1 Diabetes Mellitus: The Impact of Flash Glucose Monitoring Systems with Alarms

de Infusão de Insulina; Sono.Introdução: A diabetes mellitus tipo 1 (DMT1) requer uma monitorização intensiva e contínua.Os cuidadores dos doentes pediátricos assumem um papel fundamental na monitorização da glicose, 24 horas por dia, o que pode afetar o seu sono.Este trabalho teve como objetivo comparar a qualidade do sono dos cuidadores de crianças e adolescentes com DMT1 que utilizam sistemas de monito-Introduction: Type 1 diabetes mellitus (T1DM) requires ongoing intensive management.Caregivers of pediatric patients assume a fundamental role in glucose monitoring, 24 hours per day, which may affect their sleep.We aimed to compare the sleep quality of principal caregivers of T1DM pediatric patients who use flash glucose monitoring system (FGMS) with and without alarms and assess its impact on metabolic control.Methods: Observational and cross-sectional study of T1DM patients using an FGMS and a continuous subcutaneous insulin infusion device.The main caregiver's sleep quality was assessed through the Pittsburgh Sleep Quality Index (PSQI), and metabolic control was evaluated through the ambulatory glucose profile and HbA1c.Results: Forty-two patients and their caregivers were included, 14 children and adolescents with an alarm and 28 controls.The PSQI score showed no significant differences in parental sleep quality between groups: a median of 6.5 (IQR 7) in the alarm group and 9 (IQR 5) in the control group, p=0.348.The characterization of metabolic control (adjusted for children's age and caregivers' educational qualifications) revealed mean values of time in range (TIR) 52.17% vs 42.60% (p=0.134),time below range (TBR) 1.56% vs 5.59% (p=0.014) and glucose coefficient of variation (CV) 35.36% vs 41.62% (p=0.004) in the group with and without alarm, respectively.Conclusion: The use of alarms did not lead to a worse sleep quality or more nocturnal awakenings in caregivers of T1DM children.However, the alarms improved metabolic control by reducing TBR and glucose CV.Our results support using alarms in diabetes management without prejudice to the caregivers' sleep quality.