scholarly journals Universal Subsidized Continuous Glucose Monitoring Funding for Young People With Type 1 Diabetes: Uptake and Outcomes Over 2 Years, a Population-Based Study

Diabetes Care ◽  
2021 ◽  
pp. dc211666
Author(s):  
Stephanie R. Johnson ◽  
Deborah J. Holmes-Walker ◽  
Melissa Chee ◽  
Arul Earnest ◽  
Timothy W. Jones
Keyword(s):  
Type 1 Diabetes ◽  
Young People ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Population Based ◽  
Population Based Study

scholarly journals Use of continuous glucose monitoring trend arrows in the younger population with type 1 diabetes

2021 ◽  
Vol 18 (6) ◽  
pp. 147916412110621
Author(s):  
Nancy Elbarbary ◽  
Othmar Moser ◽  
Saif Al yaarubi ◽  
Hussain Alsaffar ◽  
Adnan Al Shaikh ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young People ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Vascular Complications ◽  
Rate Of Change ◽  
Rapid Expansion ◽  
Nocturnal Hypoglycaemia ◽  
Glucose Levels

Early control of glycaemia is key to reduce vascular complications in individuals with Type 1 diabetes. Therefore, encouraging children and adolescents with T1DM to take responsibility for controlling glucose levels is an important yet a challenging task. The rapid expansion of continuous glucose monitoring (CGM) systems has allowed for more comprehensive analysis of glycaemia in T1D. Moreover, CGM devices have the ability to calculate rate of change in glucose levels and display the information as trend arrows. In turn, this can help to take evasive actions to return glucose levels to near physiological glycaemia, which can be highly motivating for young people with T1DM. In the absence of standardised, evidence-based guidance, this consensus document, generated by experts from the Arab Society of Paediatric Endocrinology and Diabetes and international advisors, summarises recent literature on the use of trend arrows in young people with T1DM. The use of trend arrows in different CGM systems is reviewed and their clinical significance is highlighted. Adjusting insulin doses according to trend arrows is discussed while also addressing special situations, such as exercise, fasting, nocturnal hypoglycaemia and menstruation. Adequate understanding of trend arrows should facilitate optimisation of glycaemic control in the T1D population.

scholarly journals Universal Subsidized Continuous Glucose Monitoring Funding for Young People With Type 1 Diabetes: Uptake and Outcomes Over 2 Years, a Population-Based Study

2021 ◽  
Author(s):  
Stephanie R Johnson ◽  
Deborah J Holmes-Walker ◽  
Melissa Chee ◽  
Arul Earnest ◽  
Timothy W Jones ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycaemic Control ◽  
Continuous Glucose Monitoring ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Population Based ◽  
Insulin Regimen ◽  
Economic Analyses ◽  
Almost All

<b>Objective:</b> Continuous glucose monitoring (CGM) is increasingly used in type 1 diabetes management however funding models vary. This study determined the uptake rate and glycaemic outcomes following a change in national health policy to introduce universal subsidised CGM funding for people with type 1 diabetes aged < 21 years. <p><b>Research Design and Methods:</b> Analysis of longitudinal data from 12 months prior to subsidy until 24 months after. Measures and outcomes included age, diabetes duration, HbA1c, episodes of diabetic ketoacidosis and severe hypoglycaemia, insulin regimen, CGM uptake and percentage CGM use. Two data sources were used: the Australasian Diabetes Database Network (ADDN) registry (a prospective diabetes database) and the National Diabetes Supply Scheme (NDSS) registry that includes almost all individuals with type 1 diabetes nationally.</p> <p><b>Results:</b> CGM uptake increased from 5% pre-subsidy to 79% after two years. After CGM introduction, the odds ratio (OR) of achieving the HbA1c target of <7.0% improved at 12 months (OR 2.5, p<0.001) and was maintained at 24 months (OR 2.3, p<0.001). The OR for suboptimal glycaemic control (HbA1c ≥ 9.0%) decreased to 0.34 (p<0.001) at 24 months. Of CGM users, 65% used CGM >75% of time: these had a lower HbA1c at 24 months compared to those with usage <25% (7.8±1.3% vs 8.6±1.8%, respectively, p<0.001). DKA was also reduced in this group (IRR 0.49, 95% CI 0.33-0.74, p<0.001).</p> <b>Conclusions:</b> <a></a>Following national subsidy, CGM use was high and associated with sustained improvement in glycaemic control. This information will inform economic analyses and future policy and serve as a model of evaluation diabetes technologies.

scholarly journals Universal Subsidized Continuous Glucose Monitoring Funding for Young People With Type 1 Diabetes: Uptake and Outcomes Over 2 Years, a Population-Based Study

2021 ◽  
Author(s):  
Stephanie R Johnson ◽  
Deborah J Holmes-Walker ◽  
Melissa Chee ◽  
Arul Earnest ◽  
Timothy W Jones ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycaemic Control ◽  
Continuous Glucose Monitoring ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Population Based ◽  
Insulin Regimen ◽  
Economic Analyses ◽  
Almost All

<b>Objective:</b> Continuous glucose monitoring (CGM) is increasingly used in type 1 diabetes management however funding models vary. This study determined the uptake rate and glycaemic outcomes following a change in national health policy to introduce universal subsidised CGM funding for people with type 1 diabetes aged < 21 years. <p><b>Research Design and Methods:</b> Analysis of longitudinal data from 12 months prior to subsidy until 24 months after. Measures and outcomes included age, diabetes duration, HbA1c, episodes of diabetic ketoacidosis and severe hypoglycaemia, insulin regimen, CGM uptake and percentage CGM use. Two data sources were used: the Australasian Diabetes Database Network (ADDN) registry (a prospective diabetes database) and the National Diabetes Supply Scheme (NDSS) registry that includes almost all individuals with type 1 diabetes nationally.</p> <p><b>Results:</b> CGM uptake increased from 5% pre-subsidy to 79% after two years. After CGM introduction, the odds ratio (OR) of achieving the HbA1c target of <7.0% improved at 12 months (OR 2.5, p<0.001) and was maintained at 24 months (OR 2.3, p<0.001). The OR for suboptimal glycaemic control (HbA1c ≥ 9.0%) decreased to 0.34 (p<0.001) at 24 months. Of CGM users, 65% used CGM >75% of time: these had a lower HbA1c at 24 months compared to those with usage <25% (7.8±1.3% vs 8.6±1.8%, respectively, p<0.001). DKA was also reduced in this group (IRR 0.49, 95% CI 0.33-0.74, p<0.001).</p> <b>Conclusions:</b> <a></a>Following national subsidy, CGM use was high and associated with sustained improvement in glycaemic control. This information will inform economic analyses and future policy and serve as a model of evaluation diabetes technologies.

scholarly journals Continuous Glucose Monitoring Improves Glycemic Outcomes in Children With Type 1 Diabetes: Real-world Data From a Population-Based Clinic

Diabetes Care ◽  
2021 ◽  
pp. dc210304
Author(s):  
Elaine E. Sanderson ◽  
Mary B. Abraham ◽  
Grant J. Smith ◽  
Jenny A. Mountain ◽  
Timothy W. Jones ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Continuous Glucose Monitoring ◽  
Real World ◽  
Glucose Monitoring ◽  
Population Based ◽  
Real World Data ◽  
World Data ◽  
Glycemic Outcomes
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