1. Practical Approach to Using Trend Arrows on Real-Time Continuous Glucose Monitoring System in Type 1 Diabetes Adolescents Living Camp Setting Treated With Multiple Daily Injection or Continuous Subcutaneous Insulin Infusion Insulin Therapy
- Author
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Graziella Fichera, Mohamad Maghnie, Alice Parodi, Clara Rebora, Lidia Pontillo, Valentina Natoli, Marta Bassi, Nicola Minuto, Giuseppe d'Annunzio, and Marco Buccianti
- Subjects
Blood Glucose ,Adolescent ,Multiple dose regimen ,type 1 diabetes ,Injections, Subcutaneous ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Biomedical Engineering ,Bioengineering ,Insulin Infusion Systems ,Internal Medicine ,medicine ,Humans ,Hypoglycemic Agents ,Insulin ,real-time continuous glucose monitoring ,Glycated Hemoglobin ,Type 1 diabetes ,Continuous glucose monitoring ,business.industry ,Blood Glucose Self-Monitoring ,Original Articles ,medicine.disease ,Subcutaneous insulin ,Diabetes Mellitus, Type 1 ,insulin dose adjustments ,Anesthesia ,fine-tuning ,trend arrows ,business - Abstract
Background: The aim of the study was to determine the effect of an educational intervention on the use of trend arrows of a real-time continuous glucose monitoring (rt-CGM) to manage daily therapy decisions in a group of adolescents with type 1 diabetes attending a camp. The secondary aim was to evaluate the variations in total daily dose (TDD) of insulin requirement. Methods: Twenty patients (15-17 years) on multiple insulin injections ( n = 8) or continuous subcutaneous insulin infusion ( n = 12) attended a training session at the beginning of the camp to learn our algorithm for the management of therapy depending on trend arrows. TDD, time in range (TIR), time above range (TAR), and time below range (TBR) (in the 24 hours and in the three hours after breakfast) before the training session (run-in) and at the end of the camp (T1) were analyzed. Results: Data showed a reduction of TAR (run-in 42.6%, T1 32.05%, P = .036) and an increase in TIR (run-in 52.9%, T1 62.4%, P = .013). Reduction of TBR (run-in 42.5%, T1 37.5%, P = .05) and improvement in TIR (run-in 49.0%, T1 57.0%, P = .02) were also observed in the post-breakfast period. Data showed a significant reduction in the TDD (run-in 52.02 ± 17.44 U/die, T1 46.49 ± 12.39 U/die, P = .024). Conclusions: Statistically significant improvement of glycemic control and reduction of TTD were observed in all patients regardless of therapy type. The improvement between run-in and T1 demonstrates the importance of patients’ education on the correct use of rt-CGM with simple algorithms for the management of therapy.
- Published
- 2020