906-P: Safety and Efficacy of Continuous Glucose Monitoring at an ADA Camp

Personal use of Continuous Glucose Monitor (CGM) technology has increased as a tool to optimize glycemic control. CGM use at ADA camps has also risen over the past few years, however, some campers opt not to use their home CGM at camp as finger stick blood sugars were standard for monitoring glycemic control per camp protocols. At camp, kids are exposed to various levels of activity and different foods leading to variable insulin requirements compared to home regimens. This, in turn, could increase the number of potentially dangerous hypoglycemic episodes at camp if blood glucoses (BG) are not tightly monitored. The safety and efficacy of CGM in an ADA camp setting has not yet been published. This retrospective case-control quality review was performed on camper data from ADA Camp MIDICHA 2017 summer session. It was hypothesized that campers using CGM would have fewer severe glucose excursions (hypo- or hyperglycemia) compared to campers not using CGM. Of the 483 campers, 36 campers used CGM at camp. Another 36 campers (age/gender matched) who did not use CGM were identified as controls. Campers were further matched based on insulin administration method (pump vs. injections) and cabin (to reduce activity variability). BG data including average BG levels, hypoglycemic events (BG <50, <70, <80 mg/dL), and hyperglycemic events (BG >250, >300, and >400 mg/dL) were collected and analyzed. There was no significant difference in average BG levels of campers using CGM and those not using CGM (BG=179.6 vs. 178.53 mg/dL; p=0.8832). Binary logistics regressions were used to generate odds ratios for glycemic event data. Campers using CGM had a 74% lower relative risk of having at least one severe hypoglycemic episode (BG <50) during their week at camp compared to controls (14% vs. 38%; OR: 0.26 (95% CI: 0.09, 0.73); P = 0.0012). No significant differences were noted in hyperglycemia frequency amongst campers using CGM and controls. Therefore, the use of CGM should be encouraged in the camp setting to reduce the incidence of severe hypoglycemia.