647-P: Short-Term Continuous Glucose Monitoring Use in Adolescents with Type 1 Diabetes Enhances Empowerment

Background: Studies in adults with type 1 diabetes (T1D) show Continuous Glucose Monitoring (CGM) significantly lowers HbA1c however, the benefit of CGM use in adolescents has been elusive. We asked if short-term CGM use would have an effect on adolescents with poorly controlled T1D.

Methods: In a randomized open label study we recruited 12 CGM naïve subjects with T1D, with an HbA1c >8% and ages 13-18 years. Visit 1 (V1) entailed consent, survey completion (Stage of Change (SOC), Diabetes Empowerment Scale (DES-SF), Pediatric Quality of Life (PedsQL), diabetes knowledge) and randomization to treatment (T), CGM Dexcom G4 for 1 week, or control (C). Both groups received daily diabetes care communication for the 1 week between V1 and Visit 2 (V2). Visit 3 (V3) was 1 month later and Visit 4 (V4) was at 3 months. Surveys were completed at all visits and HbA1c at V1 and V4.

Results: Subjects (n=12) had an average age of 15.5 years and consisted of six Hispanic and five males. There were no significant (NS) differences between subject characteristics in the C (n=3) and T (n=9) groups. Compared to V1, there were NS changes in SOC and average number of boluses or blood glucoses (BGs) between the groups. The change in DES-SF from V1 to V4 was significant (p=0.04) for the T compared to the C. The decrease in HbA1c between V1 and V4 (-1.5%) in the T vs. an increase in the C (.4%) was NS (p=0.10) but clinically meaningful. Although NS, there was an increase in average BGs/day (+1.7) and a decrease in 7 day average BG (-81mg/dl) for T vs. the C (+0.1 BGs and -28mg/dl) from V1 to V2.

Conclusions: Research on CGM use or its emotional effects in adolescents with poorly controlled T1D is limited. This study demonstrated a significant impact on diabetes empowerment with short-term use of CGM. Although NS, this was associated with an increased number of BG checks and a decreased average BG during CGM use plus a decreased HbA1c at 3 months. Use of more advanced CGM systems may hold promise for adolescents with T1D through greater empowerment.