Lower CGM glucose is typical after the diagnosis of T1D and the initiation of insulin treatment. Although ADA guidelines now state that glycemic targets can be lower during partial clinical remission (PCR), little guidance is offered on the optimal targets. We describe CGM glucose <70 mg/dL for youth wearing CGM by PCR status. We reviewed 201 visits from 67 records; 55 visits in PCR as defined by insulin dose adjusted A1C value <9 [(HbA1c at visit)*(4*units/kg/day)]. CGM data were collected 7 days before and after each visit. In multivariate regression, controlling for age, sex, and T1D duration, proportion of time spent <70 mg/dL was calculated in a 24-hour period and at nighttime (midnight to 6am). Our cohort is 40% female, aged 9.4±4.7 years, with 92±11% wear time, and T1D duration of 126±105 days. Time spent between 54-70 mg/dL was statistically higher at nighttime for those in PCR and the time spent <54 mg/dL was minimal for both (3.4±9.3 mins/24h, Table). There were no episodes of severe hypoglycemia. Clinically significant hypoglycemia (<54 mg/dl) is rare. Furthermore, youth in PCR have time <70 mg/dL similar to youth without T1D. A threshold alarm of 65 mg/dl may reduce hypoglycemia related alarms by 50% without increasing risk of severe hypoglycemia and warrants further study. These data support a trial of lower alarm thresholds for youth in PCR who wear CGM to avoid overtreatment of clinically insignificant lows.
A. Addala: None. A. Gu: None. D. Zaharieva: Speaker’s Bureau; Self; Ascensia Diabetes Care, Insulet Corporation, Medtronic. P. Prahalad: None. B.A. Buckingham: Advisory Panel; Self; ConvaTec Inc., Medtronic. Research Support; Self; Beta Bionics, Inc., Dexcom, Inc., Insulet Corporation, Medtronic, Tandem Diabetes Care. D. Scheinker: None. D.M. Maahs: Advisory Panel; Self; Eli Lilly and Company, Insulet Corporation, Medtronic, Novo Nordisk A/S. Consultant; Self; Abbott, Sanofi. Research Support; Self; Bigfoot Biomedical, Dexcom, Inc., Roche Diabetes Care, Tandem Diabetes Care.
