Early use of continuous glucose monitoring in children and adolescents after total pancreatectomy with islet autotransplantation

Pediatr Diabetes. 2021 May;22(3):434-438. doi: 10.1111/pedi.13168. Epub 2020 Dec 10.

Abstract

Background: Children undergoing total pancreatectomy with islet autotransplantation (TPIAT) for chronic pancreatitis require intensive insulin therapy early after TPIAT with narrow glycemic targets, which can a present significant care burden. Outpatient use of continuous glucose monitoring (CGM) systems by children and caregivers early after TPIAT is inadequately studied.

Methods: In this open-label study, we randomized 14 children and adolescents (mean age 15.4 years) after hospital discharge for TPIAT to Dexcom G6 CGM (n = 7) or standard care with a glucometer (n = 7) to assess acceptability and glycemic control with use of CGM versus usual care (glucometer). Participants in the control arm also wore a blinded CGM for 1 week.

Result: Children randomized to real-time CGM had lower mean sensor glucose values compared with controls (p = 0.002), and high overall satisfaction with CGM.

Conclusions: Our data indicate that CGM is a useful adjunct to diabetes management for children who have recently undergone TPIAT.

Keywords: TPIAT; continuous glucose monitoring; diabetes technology; islet transplantation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Blood Glucose Self-Monitoring*
  • Child
  • Feasibility Studies
  • Female
  • Glycemic Control*
  • Humans
  • Islets of Langerhans Transplantation*
  • Male
  • Pancreatectomy*
  • Pancreatitis, Chronic / blood*
  • Pancreatitis, Chronic / surgery*
  • Patient Satisfaction
  • Pilot Projects
  • Transplantation, Autologous