Long-term Continuous Glucose Monitor Use in Very Young Children With Type 1 Diabetes: One-Year Results From the SENCE Study

Michelle A. Van Name; Lauren G. Kanapka; Linda A. DiMeglio; Kellee M. Miller; Anastasia Albanese-O’Neill; Persis Commissariat; Sarah D. Corathers; Kara R. Harrington; Marisa E. Hilliard; Barbara J. Anderson; Jennifer C. Kelley; Lori M. Laffel; Sarah A. MacLeish; Brandon M. Nathan; William V. Tamborlane; R. Paul Wadwa; Steven M. Willi; Kristen M. Williams; Kupper A. Wintergerst; Stephanie Woerner; Jenise C. Wong; Daniel J. DeSalvo

doi:10.1177/19322968221084667

Long-term Continuous Glucose Monitor Use in Very Young Children With Type 1 Diabetes: One-Year Results From the SENCE Study

Michelle A. Van Name, Lauren G. Kanapka, Linda A. DiMeglio, Kellee M. Miller, Anastasia Albanese-O’Neill, Persis Commissariat, Sarah D. Corathers, Kara R. Harrington, Marisa E. Hilliard, Barbara J. Anderson, Jennifer C. Kelley, Lori M. Laffel, Sarah A. MacLeish, Brandon M. Nathan, William V. Tamborlane, R. Paul Wadwa, Steven M. Willi, Kristen M. Williams, Kupper A. Wintergerst, Stephanie WoernerJenise C. Wong, Daniel J. DeSalvo

Pediatric Endocrinology

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

OBJECTIVES: Achieving optimal glycemic outcomes in young children with type 1 diabetes (T1D) is challenging. This study examined the durability of continuous glucose monitoring (CGM) coupled with a family behavioral intervention (FBI) to improve glycemia.

STUDY DESIGN: This one-year study included an initial 26-week randomized controlled trial of CGM with FBI ( CGM+FBI) and CGM alone ( Standard-CGM) compared with blood glucose monitoring (BGM), followed by a 26-week extension phase wherein the BGM Group received the CGM+FBI ( BGM-Crossover) and both original CGM groups continued this technology.

RESULTS: Time in range (70-180 mg/dL) did not improve with CGM use (CGM+FBI: baseline 37%, 52 weeks 41%; Standard-CGM: baseline 41%, 52 weeks 44%; BGM-Crossover: 26 weeks 38%, 52 weeks 40%). All three groups sustained decreases in hypoglycemia (<70 mg/dL) with CGM use (CGM+FBI: baseline 3.4%, 52 weeks 2.0%; Standard-CGM: baseline 4.1%, 52 weeks 2.1%; BGM-Crossover: 26 weeks 4.5%, 52 weeks 1.7%, P-values <.001). Hemoglobin A1c was unchanged with CGM use (CGM+FBI: baseline 8.3%, 52 weeks 8.2%; Standard-CGM: baseline 8.2%, 52 weeks 8.0%; BGM-Crossover: 26 weeks 8.1%, 52 weeks 8.3%). Sensor use remained high (52-week study visit: CGM+FBI 91%, Standard-CGM 92%, BGM-Crossover 88%).

CONCLUSION: Over 12 months young children with T1D using newer CGM technology sustained reductions in hypoglycemia and, in contrast to prior studies, persistently wore CGM. However, pervasive hyperglycemia remained unmitigated. This indicates an urgent need for further advances in diabetes technology, behavioral support, and diabetes management educational approaches to optimize glycemia in young children.

Original language	English (US)
Pages (from-to)	976-987
Number of pages	12
Journal	Journal of Diabetes Science and Technology
Volume	17
Issue number	4
DOIs	https://doi.org/10.1177/19322968221084667
State	E-pub ahead of print - Mar 2022

Bibliographical note

Funding Information:
The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: M.A.V.N., L.G.K., L.A.D., K.M.M., A.A.-O., P.C., S.D.C., K.R.H., M.E.H., B.J.A., J.C.K., S.A.M., B.M.N., W.V.T., K.M.W., K.A.W., S.W., and J.C.W. have no disclosures to report. L.M.L. reports grants and personal fees from Dexcom, outside the submitted work. R.P.W. reports grants from Dexcom, Eli Lilly, and Tandem Diabetes Care and personal fees from Dompe and Tandem Diabetes Care outside the submitted work. S.M.W. reports personal fees from Roche Diagnostics and Boehringer Ingelheim, outside the submitted work. D.J.D. reports research support from Insulet and personal fees from Dexcom outside the submitted work.

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Supported by the Leona M. and Harry B. Helmsley Trust, Dexcom Inc provided nonfinancial support.

Publisher Copyright:
© 2022 Diabetes Technology Society.

Keywords

behavioral intervention
continuous glucose monitoring
glycemic control
hypoglycemia
young children

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1177/19322968221084667

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Van Name, M. A., Kanapka, L. G., DiMeglio, L. A., Miller, K. M., Albanese-O’Neill, A., Commissariat, P., Corathers, S. D., Harrington, K. R., Hilliard, M. E., Anderson, B. J., Kelley, J. C., Laffel, L. M., MacLeish, S. A., Nathan, B. M., Tamborlane, W. V., Wadwa, R. P., Willi, S. M., Williams, K. M., Wintergerst, K. A., ... DeSalvo, D. J. (2022). Long-term Continuous Glucose Monitor Use in Very Young Children With Type 1 Diabetes: One-Year Results From the SENCE Study. Journal of Diabetes Science and Technology, 17(4), 976-987. Advance online publication. https://doi.org/10.1177/19322968221084667

Van Name, MA, Kanapka, LG, DiMeglio, LA, Miller, KM, Albanese-O’Neill, A, Commissariat, P, Corathers, SD, Harrington, KR, Hilliard, ME, Anderson, BJ, Kelley, JC, Laffel, LM, MacLeish, SA, Nathan, BM, Tamborlane, WV, Wadwa, RP, Willi, SM, Williams, KM, Wintergerst, KA, Woerner, S, Wong, JC & DeSalvo, DJ 2022, 'Long-term Continuous Glucose Monitor Use in Very Young Children With Type 1 Diabetes: One-Year Results From the SENCE Study', Journal of Diabetes Science and Technology, vol. 17, no. 4, pp. 976-987. https://doi.org/10.1177/19322968221084667

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title = "Long-term Continuous Glucose Monitor Use in Very Young Children With Type 1 Diabetes: One-Year Results From the SENCE Study",

abstract = "OBJECTIVES: Achieving optimal glycemic outcomes in young children with type 1 diabetes (T1D) is challenging. This study examined the durability of continuous glucose monitoring (CGM) coupled with a family behavioral intervention (FBI) to improve glycemia.STUDY DESIGN: This one-year study included an initial 26-week randomized controlled trial of CGM with FBI ( CGM+FBI) and CGM alone ( Standard-CGM) compared with blood glucose monitoring (BGM), followed by a 26-week extension phase wherein the BGM Group received the CGM+FBI ( BGM-Crossover) and both original CGM groups continued this technology. RESULTS: Time in range (70-180 mg/dL) did not improve with CGM use (CGM+FBI: baseline 37%, 52 weeks 41%; Standard-CGM: baseline 41%, 52 weeks 44%; BGM-Crossover: 26 weeks 38%, 52 weeks 40%). All three groups sustained decreases in hypoglycemia (<70 mg/dL) with CGM use (CGM+FBI: baseline 3.4%, 52 weeks 2.0%; Standard-CGM: baseline 4.1%, 52 weeks 2.1%; BGM-Crossover: 26 weeks 4.5%, 52 weeks 1.7%, P-values <.001). Hemoglobin A1c was unchanged with CGM use (CGM+FBI: baseline 8.3%, 52 weeks 8.2%; Standard-CGM: baseline 8.2%, 52 weeks 8.0%; BGM-Crossover: 26 weeks 8.1%, 52 weeks 8.3%). Sensor use remained high (52-week study visit: CGM+FBI 91%, Standard-CGM 92%, BGM-Crossover 88%). CONCLUSION: Over 12 months young children with T1D using newer CGM technology sustained reductions in hypoglycemia and, in contrast to prior studies, persistently wore CGM. However, pervasive hyperglycemia remained unmitigated. This indicates an urgent need for further advances in diabetes technology, behavioral support, and diabetes management educational approaches to optimize glycemia in young children.",

keywords = "behavioral intervention, continuous glucose monitoring, glycemic control, hypoglycemia, young children",

author = "{Van Name}, {Michelle A.} and Kanapka, {Lauren G.} and DiMeglio, {Linda A.} and Miller, {Kellee M.} and Anastasia Albanese-O{\textquoteright}Neill and Persis Commissariat and Corathers, {Sarah D.} and Harrington, {Kara R.} and Hilliard, {Marisa E.} and Anderson, {Barbara J.} and Kelley, {Jennifer C.} and Laffel, {Lori M.} and MacLeish, {Sarah A.} and Nathan, {Brandon M.} and Tamborlane, {William V.} and Wadwa, {R. Paul} and Willi, {Steven M.} and Williams, {Kristen M.} and Wintergerst, {Kupper A.} and Stephanie Woerner and Wong, {Jenise C.} and DeSalvo, {Daniel J.}",

note = "Funding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: M.A.V.N., L.G.K., L.A.D., K.M.M., A.A.-O., P.C., S.D.C., K.R.H., M.E.H., B.J.A., J.C.K., S.A.M., B.M.N., W.V.T., K.M.W., K.A.W., S.W., and J.C.W. have no disclosures to report. L.M.L. reports grants and personal fees from Dexcom, outside the submitted work. R.P.W. reports grants from Dexcom, Eli Lilly, and Tandem Diabetes Care and personal fees from Dompe and Tandem Diabetes Care outside the submitted work. S.M.W. reports personal fees from Roche Diagnostics and Boehringer Ingelheim, outside the submitted work. D.J.D. reports research support from Insulet and personal fees from Dexcom outside the submitted work. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Supported by the Leona M. and Harry B. Helmsley Trust, Dexcom Inc provided nonfinancial support. Publisher Copyright: {\textcopyright} 2022 Diabetes Technology Society.",

year = "2022",

month = mar,

doi = "10.1177/19322968221084667",

language = "English (US)",

volume = "17",

pages = "976--987",

journal = "Journal of Diabetes Science and Technology",

issn = "1932-2968",

publisher = "Diabetes Technology Society",

number = "4",

}

TY - JOUR

T1 - Long-term Continuous Glucose Monitor Use in Very Young Children With Type 1 Diabetes

T2 - One-Year Results From the SENCE Study

AU - Van Name, Michelle A.

AU - Kanapka, Lauren G.

AU - DiMeglio, Linda A.

AU - Miller, Kellee M.

AU - Albanese-O’Neill, Anastasia

AU - Commissariat, Persis

AU - Corathers, Sarah D.

AU - Harrington, Kara R.

AU - Hilliard, Marisa E.

AU - Anderson, Barbara J.

AU - Kelley, Jennifer C.

AU - Laffel, Lori M.

AU - MacLeish, Sarah A.

AU - Nathan, Brandon M.

AU - Tamborlane, William V.

AU - Wadwa, R. Paul

AU - Willi, Steven M.

AU - Williams, Kristen M.

AU - Wintergerst, Kupper A.

AU - Woerner, Stephanie

AU - Wong, Jenise C.

AU - DeSalvo, Daniel J.

N1 - Funding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: M.A.V.N., L.G.K., L.A.D., K.M.M., A.A.-O., P.C., S.D.C., K.R.H., M.E.H., B.J.A., J.C.K., S.A.M., B.M.N., W.V.T., K.M.W., K.A.W., S.W., and J.C.W. have no disclosures to report. L.M.L. reports grants and personal fees from Dexcom, outside the submitted work. R.P.W. reports grants from Dexcom, Eli Lilly, and Tandem Diabetes Care and personal fees from Dompe and Tandem Diabetes Care outside the submitted work. S.M.W. reports personal fees from Roche Diagnostics and Boehringer Ingelheim, outside the submitted work. D.J.D. reports research support from Insulet and personal fees from Dexcom outside the submitted work. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Supported by the Leona M. and Harry B. Helmsley Trust, Dexcom Inc provided nonfinancial support. Publisher Copyright: © 2022 Diabetes Technology Society.

PY - 2022/3

Y1 - 2022/3

N2 - OBJECTIVES: Achieving optimal glycemic outcomes in young children with type 1 diabetes (T1D) is challenging. This study examined the durability of continuous glucose monitoring (CGM) coupled with a family behavioral intervention (FBI) to improve glycemia.STUDY DESIGN: This one-year study included an initial 26-week randomized controlled trial of CGM with FBI ( CGM+FBI) and CGM alone ( Standard-CGM) compared with blood glucose monitoring (BGM), followed by a 26-week extension phase wherein the BGM Group received the CGM+FBI ( BGM-Crossover) and both original CGM groups continued this technology. RESULTS: Time in range (70-180 mg/dL) did not improve with CGM use (CGM+FBI: baseline 37%, 52 weeks 41%; Standard-CGM: baseline 41%, 52 weeks 44%; BGM-Crossover: 26 weeks 38%, 52 weeks 40%). All three groups sustained decreases in hypoglycemia (<70 mg/dL) with CGM use (CGM+FBI: baseline 3.4%, 52 weeks 2.0%; Standard-CGM: baseline 4.1%, 52 weeks 2.1%; BGM-Crossover: 26 weeks 4.5%, 52 weeks 1.7%, P-values <.001). Hemoglobin A1c was unchanged with CGM use (CGM+FBI: baseline 8.3%, 52 weeks 8.2%; Standard-CGM: baseline 8.2%, 52 weeks 8.0%; BGM-Crossover: 26 weeks 8.1%, 52 weeks 8.3%). Sensor use remained high (52-week study visit: CGM+FBI 91%, Standard-CGM 92%, BGM-Crossover 88%). CONCLUSION: Over 12 months young children with T1D using newer CGM technology sustained reductions in hypoglycemia and, in contrast to prior studies, persistently wore CGM. However, pervasive hyperglycemia remained unmitigated. This indicates an urgent need for further advances in diabetes technology, behavioral support, and diabetes management educational approaches to optimize glycemia in young children.

AB - OBJECTIVES: Achieving optimal glycemic outcomes in young children with type 1 diabetes (T1D) is challenging. This study examined the durability of continuous glucose monitoring (CGM) coupled with a family behavioral intervention (FBI) to improve glycemia.STUDY DESIGN: This one-year study included an initial 26-week randomized controlled trial of CGM with FBI ( CGM+FBI) and CGM alone ( Standard-CGM) compared with blood glucose monitoring (BGM), followed by a 26-week extension phase wherein the BGM Group received the CGM+FBI ( BGM-Crossover) and both original CGM groups continued this technology. RESULTS: Time in range (70-180 mg/dL) did not improve with CGM use (CGM+FBI: baseline 37%, 52 weeks 41%; Standard-CGM: baseline 41%, 52 weeks 44%; BGM-Crossover: 26 weeks 38%, 52 weeks 40%). All three groups sustained decreases in hypoglycemia (<70 mg/dL) with CGM use (CGM+FBI: baseline 3.4%, 52 weeks 2.0%; Standard-CGM: baseline 4.1%, 52 weeks 2.1%; BGM-Crossover: 26 weeks 4.5%, 52 weeks 1.7%, P-values <.001). Hemoglobin A1c was unchanged with CGM use (CGM+FBI: baseline 8.3%, 52 weeks 8.2%; Standard-CGM: baseline 8.2%, 52 weeks 8.0%; BGM-Crossover: 26 weeks 8.1%, 52 weeks 8.3%). Sensor use remained high (52-week study visit: CGM+FBI 91%, Standard-CGM 92%, BGM-Crossover 88%). CONCLUSION: Over 12 months young children with T1D using newer CGM technology sustained reductions in hypoglycemia and, in contrast to prior studies, persistently wore CGM. However, pervasive hyperglycemia remained unmitigated. This indicates an urgent need for further advances in diabetes technology, behavioral support, and diabetes management educational approaches to optimize glycemia in young children.

KW - behavioral intervention

KW - continuous glucose monitoring

KW - glycemic control

KW - hypoglycemia

KW - young children

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Long-term Continuous Glucose Monitor Use in Very Young Children With Type 1 Diabetes: One-Year Results From the SENCE Study

Abstract

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Keywords

UN SDGs

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