Journal of Diabetology

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Short Communication - Journal of Diabetology (2022) Volume 6, Issue 5

Teens and millennials with hyperglycaemia and the implications of tracking on glycaemic control.

Marco Marigliano*

Department of Pediatric Diabetes and Metabolic Disorders Unit, Regional Center for Pediatric Diabetes, University City Hospital of Verona, Verona, Italy.

*Corresponding Author:
Marco Marigliano
Department of Pediatric Diabetes and Metabolic Disorders Unit
Regional Center for Pediatric Diabetes
University City Hospital of Verona, Verona, Italy
E-mail: [email protected]

Received: 19-Aug-2022, Manuscript No. AADY-22-77529; Editor assigned: 29-Aug-2022, PreQC No. AADY-22-77529 (PQ); Reviewed: 05-Sept-2022, QC No AADY-22-77529; Revised: 19-Sept-2022, Manuscript No. AADY-22-77529 (R); Published: 23-Sept-2022, DOI: 10.35841/aady-6.5.123

Citation: Marigliano M. Teens and millennials with hyperglycaemia and the implications of tracking on glycaemic control. J Diabetol. 2022;6(5):123

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Abstract

Adolescents and young adults with type 1 diabetes had the lowest glycemic control of any age group with type 1 diabetes. Although continuous glucose monitoring (CGM) has been shown to improve glycemic control in adults, its benefit in adolescents and young adults has not been demonstrated Randomized clinical trial conducted Between January 2018 and May 2019, 14 endocrinology practises in the United States recruited 153 people aged 14 to 24 with type 1 diabetes and screening haemoglobin A1c (HbA1c) levels ranging from 7.5% to 10.9%. HbA1c change from baseline to 26 weeks was the primary endpoint. There were 20 secondary outcomes, which included additional HbA1c outcomes, CGM glucose measures, and patient-reported outcomes with multiple comparisons adjusted.

Introduction

In the T1D Exchange clinic registry, glycaemic management remained unsatisfactory in the majority of adolescents and young adults with type 1 diabetes, with just 17% meeting the 2019 American Diabetes Association's haemoglobin A1C (HbA1c) target of less than 7.5% and 14% meeting the objective of less than 7%. Continuous glucose monitoring (CGM) devices give users with real-time glucose readings, trends, and alarms to help them make diabetes treatment decisions. Although CGM has been found to enhance glucose control in adults, trials in adolescents and young adults have not shown an overall effect (although for the minority of adolescents and young adults who used CGM regularly, a benefit was observed). These investigations made use of CGM devices from a previous generation.

Study management and supervision

This randomised clinical trial was carried out at 14 endocrinology practises in the United States [1]. Institutional review boards accepted the protocol and informed consent/ assent forms that complied with the Health Insurance Portability and Accountability Act. Prior to participation, each participant and parent/legal guardian, where applicable, provided written informed consent with or without assent [2]. An impartial data and safety monitoring board oversaw the trial's examination of safety data. Supplement 1 contains the protocol and the statistical analysis strategy.

The assessment of safety

Reportable adverse events included severe hypoglycemia (defined as an event that required assistance from another person due to altered consciousness), hyperglycemia resulting in evaluation or treatment at a health care provider facility or that involved diabetic ketoacidosis, device-related events with potential effects on participant safety, and all serious adverse events regardless of causality [3].

CGM metrics

In the CGM group, the mean percentage of time in the target glucose range of 70 to 180 mg/dL was 37% (9.0 h/d) at baseline and 43% (10.3 h/d) during follow-up, and in the BGM group, it was 36% (8.7 h/d) at baseline and 35% (8.3 h/d) during follow-up[4] (adjusted between-group difference, 6.9% [1.7 h/d] [95% CI Supplement 2 shows the percentages of time spent in the target glucose range during the day and night. The CGM group spent considerably less time in hypoglycemia (glucose 70 mg/dL) than the BGM group (adjusted betweengroup difference, 0.7% [95% CI, 1.5% to 0.1%]; P=.002 [5].

Conclusions

Among adolescents and young adults with type 1 diabetes, continuous glucose monitoring compared with standard blood glucose monitoring resulted in a small but statistically significant improvement in glycemic control over 26 weeks. Further research is needed to understand the clinical importance of the findings.

References

  1. Laffel LM, Kanapka LG, Beck RW, et al. Effect of continuous glucose monitoring on glycemic control in adolescents and young adults with type 1 diabetes: a randomized clinical trial. Jama. 2020;323(23):2388-96.
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  3. Wong CA, Miller VA, Murphy K, et al. Effect of financial incentives on glucose monitoring adherence and glycemic control among adolescents and young adults with type 1 diabetes: a randomized clinical trial. JAMA pediatrics. 2017;171(12):1176-83.
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  5. DeSalvo DJ, Miller KM, Hermann JM, et al. Continuous glucose monitoring and glycemic control among youth with type 1 diabetes: International comparison from the T1D Exchange and DPV Initiative. Pediatric diabetes. 2018;19(7):1271-5.
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  7. Herzer M, Hood KK. Anxiety symptoms in adolescents with type 1 diabetes: association with blood glucose monitoring and glycemic control. Journal of pediatric psychology. 2010;35(4):415-25.
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  9. McGrady ME, Laffel L, Drotar D, et al. Depressive symptoms and glycemic control in adolescents with type 1 diabetes: mediational role of blood glucose monitoring. Diabetes care. 2009;32(5):804-6.
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