Impact of Continuous Glucose Monitoring on Hemoglobin A1c and Height Trends in Latin American Children with Type 1 Diabetes Onset over 3 Years: A Multicenter Study

• Published in: Journal of pediatrics. Clinical practice 2024-12, Vol.14, p.200130, Article 200130
• Main Authors: Hirschler, Valeria, Molinari, Claudia, Gonzalez, Claudio D., Andres, Maria Eugenia, Sobrero, Angela Figueroa, Femenia, Victoria, Pietropaolo, Guadalupe, Major, Maria L., Scaiola, Edit, Mazzetti, Sandra, Pasayo, Patricia, Benitez, Amanda J., Marassi, Andrea Escalante, Pardo, Laura, Pelicand, Julie, Del Aguila Villar, Carlos M., Franchello, Alejandra, Bogado, Ernesto, Pomilio, Julieta, Flores, Rosa, Rusca, Elizabeth Garcia, Reinoso, Andrea Soledad, Morin, Analia, Rossi, Eduardo, Vacarezza, Veronica, Fuentes, Daniela Rodríguez, Paz Povedano, Paula, Garcia, Ana L., Martinez, Teresa, Blanco, Fabiola, Almache, Oswaldo Núñez, Parada, Ana, Bocco, Patricia, Arzamendia, M Laura, Mannucci, Carla, Taberner, Patricia, Braguinsky, Laura
• Format: Article
• Language: English
• Subjects: CGM; height; Latin American children; Original; type 1 diabetes
• ISSN: 2950-5410; 2950-5410
• DOI: 10.1016/j.jpedcp.2024.200130

To evaluate changes in hemoglobin A1c (HbA1c) levels and z-height over 3 years based on continuous glucose monitoring (CGM) usage among children with new-onset type 1 diabetes (T1DM) from various Latin American centers. Data on z-height, CGM access, and HbA1c (%) were collected for Latin American children aged 6 months to 18 years with T1DM onset from 19 centers in a retrospective analysis of medical records, from 2020 to 2023. A 2-way ANOVA method with repeated measures and multiple regression analyses were performed. We included 433 children (46.0% female) aged 8.7 ± 3.7 years; 199 (45.9%) used CGM. The mean HbA1c was significantly lower in years 1, 2, and 3 than at baseline in children with CGM, but not those without CGM. The z-height decreased significantly with the years in both groups. However, the CGM users showed a significantly greater height in years 2 and 3 than the nonusers. Multiple linear regression analysis showed that CGM users exhibited a significantly lower incremental area under the curve (AUC) for HbA1c during follow-up than nonusers. Furthermore, a lower incremental AUC for HbA1c was associated with a smaller decremental AUC for z-height (R2 = 0.19). Multiple logistic regression analysis revealed that children with CGM were 80% more likely (OR, 0.22; 95% CI, 0.1-0.6) to achieve an HbA1c of