| Objective:To investigate the effect of Flash Glucose Monitoring(Flash Glucose Monitoring,FGM)on blood Glucose control and child satisfaction in children with Type1 diabetes mellitus(T1DM)receiving intensive insulin therapy.Methods:142 children with T1DM who were admitted to the Department of Endocrinology and Metabolism of Qingdao Women and Children’s Hospital from November 2016 to May 2021 and followed up regularly were selected as subjects.(1)Data collection:data related to gender,age,height,weight,course of disease,self-monitoring frequency of blood glucose,Hb A1c,target range of time,insulin dosage,C-peptide,insulin and so on were collected in outpatient,ward and telephone follow-up visits.Insulin and C-peptide were the results of regular outpatient review.(2)Questionnaire survey:to understand the general situation of the children(such as family income,blood glucose management and education,diet control,daily exercise time,reasons for choosing FGM and application satisfaction,etc.).(3)group:Parents and children were included in the FGM group and SMBG(Self Monitoring Of Blood Glucose)group according to their own decision on whether to wear FGM or not.Children wearing FGM were divided into FGM+CSII(Continuous Subcutaneous Insulin Infusion)and FGM+MDI(Multiple Daily insulin injection)injection group according to different injection methods.Results:(1)A total of 142 children were included,including 82 children in the FGM group,with a mean age of(9.26±3.67)years,a mean course of disease of(2.11±0.89)years,and a mean BMI of(19.52±3.50)kg/m~2;In SMBG group(60 cases),the mean age was(10.39±3.52)years old,the mean course of disease was(2.67±1.21)years old,and the mean BMI was(17.75±3.95)kg/m~2.(2)There was no difference in baseline characteristics of Hb A1c between the two groups,which was comparable.Compared with SMBG group,the insulin dosage in the first year,Hb A1c and the incidence of hypoglycemia in the second year of blood glucose monitoring in FGM group were significantly lower,with statistical significance(P<0.05).(2)Effects of wearing FGM combined with different insulin injection methods on blood glucose control In 82 T1DM children wearing FGM,Hb A1c(6.4%)in the combined CSIIgroupwassignificantlylowerthanthatinthe MDIgroup(7.1%)in the second year after use.The TIR of children combined with CSII(79%)was better than that of children using MDI(76%),and the differences were statistically significant(P<0.05).(3)After analysis of related factors,children with T1DM who wear FGM,follow diabetic diet,exercise for more than 60 minutes a day,and return visit for less than 6months had better blood glucose control,with statistically significant differences(P<0.05).(4)The satisfaction of T1DM children with FGM was investigated,among which 63(77.9%)were relatively satisfied,11(12.8%)were very satisfied,and 8(9.3%)were dissatisfied.The original intention of choosing FGM was painless and convenient blood glucose monitoring(97.67%),reducing the frequency of hypoglycemia(54.65%),eating more freely(47.67%),and understanding the trend of blood glucose(3.49%).Adverse reactions included sensor shedding(31.9%),skin allergy(23.5%),scanner malfunction(11.7%),bleeding(4.2%),etc.Reasons for rejection of FGM included long-term implantation of fear needle(5.81%),inconvenient activities(4.65%),and influence on social interaction(3.49%).Most of the children(91.86%)had nodiscomfort.Conclusion:(1)For children with T1DM undergoing intensive treatment,wearing FGM is beneficial to blood glucose control and can significantly reduce the dosage of Hb A1c and insulin and the incidence of hypoglycemia.(2)FGM combined with CSII can not only betterreduce Hb A1c,butalsosignificantlyimprove TIR,which is the ideal choice for intensive treatment of T1DM in children(.3)Children using FGM andtheir families have a high degree of satisfaction,and painless and convenient blood glucose monitoring is the primary intention of their choice. |
PDF Full Text Request