Aims: To characterize the use of Flash Glucose Monitoring (FGM) in type 1 diabetic patients in a pediatric hospital one year after reimbursement by the public health insurance in Belgium.

Methods: This retrospective study included all type 1 diabetic children and adolescents who switched to FGM with specific education in our center and for whom A1c, FGM data, and severe hypoglycemic records were available.

Results: On the 334 subjects (aged 4-20 years) included, 56 (16.8%) refused to use FGM. At baseline, users were younger [median (IQR)] (13.6 (10.9-16.3) vs. 15.2 (12.2-17.5) years; p=0.012) and performed more SMBG tests (4.3 (3.8-5.0) vs. 4.1 (3.5-4.4) per day; p=0.008) than non-users. During follow-up, FGM users increased glucose monitoring from 4.3 (3.8-5.0) to 7.0 (5.0-10.0) time per day (p=0.011) while severe hypoglycemic events decreased from 6.8% to 0.9% (p=0.011). At the end of follow-up (12.7 (11.9-13.5) months), there were less severe hypoglycemic events in FGM users than in non-users (0.9% vs. 8.9%; p=0.026) but no difference in A1c. In multivariate analysis, ΔA1c during follow-up was independently related to A1c at baseline (R=0.419; p<0.001) for FGM users, and negatively with the frequency of glucose scans (R=0.160; p<0.001).

Conclusions: FGM is well accepted in our pediatric population and decreased the risk of severe hypoglycemic events, without changing A1c after one-year follow-up in youth with good glycemic control at baseline.

A. Messaaoui: None. S. Tenoutasse: None. L. Crenier: None.

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