Effect of nationwide reimbursement of real-time continuous glucose monitoring on HbA1c, hypoglycemia and quality of life in a pediatric type 1 diabetes population: The RESCUE-pediatrics study.

De Ridder, Francesca; Charleer, Sara; Jacobs, Seppe; Bolsens, Nancy; Ledeganck, Kristien J; Van Aken, Sara; Vanbesien, Jesse; Gies, Inge; Casteels, Kristina; Massa, Guy; Lysy, Philippe A; Logghe, Karl; Lebrethon, Marie-Christine; Depoorter, Sylvia; Gillard, Pieter; De Block, Christophe; den Brinker, Marieke

doi:10.3389/fped.2022.991633

Article (Scientific journals)

Effect of nationwide reimbursement of real-time continuous glucose monitoring on HbA1c, hypoglycemia and quality of life in a pediatric type 1 diabetes population: The RESCUE-pediatrics study.

De Ridder, Francesca; Charleer, Sara; Jacobs, Seppe et al.

2022 • In Frontiers in Pediatrics, 10, p. 991633

Peer Reviewed verified by ORBi

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https://hdl.handle.net/2268/300254

DOI
10.3389/fped.2022.991633

PubMed
36275049

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Effect of nationwide reimbursement of real-time continuous glucose monitoring on HbA1c hypoglycemia and quality of life in a pediatric type 1 diabetes population The RESCUE pediatrics study.txt

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Keywords :

HbA1c; hypoglycemia; quality of life; real-time continuous glucose monitoring (RT-CGM); time in range; type 1 diabetes; Pediatrics, Perinatology and Child Health

Abstract :

[en] [en] OBJECTIVE: Real-time continuous glucose monitoring (RT-CGM) can improve metabolic control and quality of life (QoL), but long-term real-world data in children with type 1 diabetes (T1D) are scarce. Over a period of 24 months, we assessed the impact of RT-CGM reimbursement on glycemic control and QoL in children/adolescents with T1D treated with insulin pumps. RESEARCH DESIGN AND METHODS: We conducted a multicenter prospective observational study. Primary endpoint was the change in HbA1c. Secondary endpoints included change in time in hypoglycemia, QoL, hospitalizations for hypoglycemia and/or ketoacidosis and absenteeism (school for children, work for parents). RESULTS: Between December 2014 and February 2019, 75 children/adolescents were followed for 12 (n = 62) and 24 months (n = 50). Baseline HbA1c was 7.2 ± 0.7% (55 ± 8mmol/mol) compared to 7.1 ± 0.8% (54 ± 9mmol/mol) at 24 months (p = 1.0). Participants with a baseline HbA1c ≥ 7.5% (n = 27, mean 8.0 ± 0.3%; 64 ± 3mmol/mol) showed an improvement at 4 months (7.6 ± 0.7%; 60 ± 8mmol/mol; p = 0.009) and at 8 months (7.5 ± 0.6%; 58 ± 7mmol/mol; p = 0.006), but not anymore thereafter (endpoint 24 months: 7.7 ± 0.9%; 61 ± 10mmol/mol; p = 0.2). Time in hypoglycemia did not change over time. QoL for parents and children remained stable. Need for assistance by ambulance due to hypoglycemia reduced from 8 to zero times per 100 patient-years (p = 0.02) and work absenteeism for parents decreased from 411 to 214 days per 100 patient-years (p = 0.03), after 24 months. CONCLUSION: RT-CGM in pump-treated children/adolescents with T1D showed a temporary improvement in HbA1c in participants with a baseline HbA1c ≥ 7.5%, without increasing time in hypoglycemia. QoL was not affected. Importantly, RT-CGM reduced the need for assistance by ambulance due to hypoglycemia and reduced work absenteeism for parents after 24 months. CLINICAL TRIAL REGISTRATION: [ClinicalTrials.gov], identifier [NCT02601729].

Disciplines :

Endocrinology, metabolism & nutrition
Pediatrics

Author, co-author :

De Ridder, Francesca; Laboratory of Experimental Medicine and Pediatrics (LEMP) and Member of the Infla-Med Center of Excellence, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium ; Department of Endocrinology-Diabetology-Metabolism, Antwerp University Hospital (UZA), Antwerp, Belgium ; Fund for Scientific Research (FWO), Brussels, Belgium

Charleer, Sara; Department of Endocrinology, University Hospitals Leuven, Catholic University of Leuven (KU Leuven), Leuven, Belgium

Jacobs, Seppe; Department of Endocrinology-Diabetology-Metabolism, Antwerp University Hospital (UZA), Antwerp, Belgium

Bolsens, Nancy; Department of Endocrinology-Diabetology-Metabolism, Antwerp University Hospital (UZA), Antwerp, Belgium

Ledeganck, Kristien J; Laboratory of Experimental Medicine and Pediatrics (LEMP) and Member of the Infla-Med Center of Excellence, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium

Van Aken, Sara; Department of Pediatrics, University Hospital Ghent, Ghent, Belgium

Vanbesien, Jesse; Department of Pediatrics, University Hospital Brussels, Free University of Brussels (VUB), Brussels, Belgium

Gies, Inge; Department of Pediatrics, University Hospital Brussels, Free University of Brussels (VUB), Brussels, Belgium

Casteels, Kristina; Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium ; Department of Development and Regeneration, KU Leuven, Leuven, Belgium

Massa, Guy; Department of Pediatrics, Jessa Hospital, Hasselt, Belgium

More authors (7 more)

Language :

English

Title :

Effect of nationwide reimbursement of real-time continuous glucose monitoring on HbA1c, hypoglycemia and quality of life in a pediatric type 1 diabetes population: The RESCUE-pediatrics study.

Publication date :

2022

Journal title :

Frontiers in Pediatrics

eISSN :

2296-2360

Publisher :

Frontiers Media S.A., Switzerland

Volume :

Pages :

991633

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://www.frontiersin.org/articles/10.3389/fped.2022.991633/full

Funding text :

KU Leuven received non-financial support for travel from Medtronic and financial support for travel from Roche for SC. MB reports travel grants from Abbott, Medtronic, Novo-Nordisk, and had served on the advisory panel for Novo Nordisk. KC reports travel grants from Medtronic, Sandoz, and has served in an advisory panel for Novo Nordisk. CDB reports consulting fees and honoraria for speaking for Abbott, AstraZeneca, Boehringer-Ingelheim, A. Menarini Diagnostics, Eli Lilly, Medtronic, Novo Nordisk, and Roche. PG serves or has served on the advisory panel for Novo Nordisk, Sanofi-Aventis, Boehringer-Ingelheim, Janssen Pharmaceuticals, Roche, Medtronic, and Bayer. Financial compensation for these activities has been received by KU Leuven. PG serves or has served on the speaker’s bureau for Merck Sharp and Dohme, Boehringer-Ingelheim, Bayer, Medtronic, Insulet, Novo Nordisk, Abbott, and Roche. Financial compensation for these activities has been received by KU Leuven. KU Leuven received for PG non-financial support for travel from Sanofi-Aventis, A. Menarini Diagnostics, Medtronic, and Roche. All disclosures were unrelated to the present work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.FDR (1S62821N) and SC (1S13517N) (until 31 December 2020) received a doctoral grant strategic basic research and PG received a grant for a clinical Ph.D. fellowship from FWO (Fonds Wetenschappelijk Onderzoek).

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