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Accuracy and impact on quality of life of real-time continuous glucose monitoring in children with hyperinsulinaemic hypoglycaemia

Sivasubramanian, Madhini, Gilbert, Clare, Doodson, Louise, Avari, Parizad, Morgan, Kate, Oliver, Nick and Shah, Pratik (2023) Accuracy and impact on quality of life of real-time continuous glucose monitoring in children with hyperinsulinaemic hypoglycaemia. Accuracy and impact on quality of life of real-time continuous glucose monitoring in children with hyperinsulinaemic hypoglycaemia, 14. ISSN 1664-2392

Item Type: Article

Abstract

Objective: Continuous glucose monitoring (CGM) is the standard of care for glucose monitoring in children with diabetes, however there are limited data reporting their use in hyperinsulinaemic hypoglycaemia (HH). Here, we evaluate CGM accuracy and its impact on quality of life in children with HH.

Methods: Real-time CGM (Dexcom G5 and G6) was used in children with HH aged 0-16years. Data from self-monitoring capillary blood glucose (CBG) and CGM were collected over a period of up to 28days and analysed. Quality of life was assessed by the PedsQL4.0 general module and PedsQL2.0 family impact module, completed by children and their parents/carers before and after CGM insertion. Analysis of accuracy metrics included mean absolute relative difference (MARD) and proportion of CGM values within 15, 20, and 30% or 15, 20, and 30 mg/dL of reference glucose values >100 mg/dL or ≤100 mg/dL, respectively (% 15/15, % 20/20, % 30/30). Clinical reliability was assessed with Clarke error grid (CEG) analyses.

Results: Prospective longitudinal study with data analysed from 40 children. The overall MARD between reference glucose and paired CGM values (n=4,928) was 13.0% (Dexcom G5 12.8%, Dexcom G6 13.1%). The proportion of readings meeting %15/15 and %20/20 were 77.3% and 86.4%, respectively, with CEG analysis demonstrating 97.4% of all values in zones A and B. Within the hypoglycaemia range (<70 mg/dL), the median ARD was 11.4% with a sensitivity and specificity of 64.2% and 91.3%, respectively. Overall PedsQL child report at baseline and endpoint were 57.6 (50.5 – 75.8) and 87.0 (82.9 – 91.2), and for parents were 60.3 (44.8 – 66.0) and 85.3 (83.7 – 91.3), respectively (both p<0.001).

Conclusion: Use of CGM for children with HH is feasible, with clinically acceptable accuracy, particularly in the hypoglycaemic range. Quality of life measures demonstrate significant improvement after CGM use. These data are important to explore use of CGM in disease indications, including neonatal and paediatric diabetes, cystic fibrosis and glycogen storage disorders.

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More Information

Uncontrolled Keywords: hyperinsulinism, continuous glucose monitoring, hypoglycaemia, neurodevelopment, time below range
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Depositing User: Madhini Sivasubramanian

Identifiers

Item ID: 16701
Identification Number: doi.org/10.3389/fendo.2023.1265076
ISSN: 1664-2392
URI: http://sure.sunderland.ac.uk/id/eprint/16701
Official URL: https://www.frontiersin.org/

Users with ORCIDS

ORCID for Madhini Sivasubramanian: ORCID iD orcid.org/0000-0001-8358-2453

Catalogue record

Date Deposited: 06 Oct 2023 12:09
Last Modified: 06 Oct 2023 12:15

Contributors

Author: Madhini Sivasubramanian ORCID iD
Author: Clare Gilbert
Author: Louise Doodson
Author: Parizad Avari
Author: Kate Morgan
Author: Nick Oliver
Author: Pratik Shah

University Divisions

Faculty of Health Sciences and Wellbeing > School of Nursing and Health Sciences

Subjects

Sciences > Nursing

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