Published online Nov 15, 2021. doi: 10.4239/wjd.v12.i11.1908
Peer-review started: May 31, 2021
First decision: July 3, 2021
Revised: July 14, 2021
Accepted: September 15, 2021
Article in press: September 15, 2021
Published online: November 15, 2021
Type 1 diabetes (T1D) affects a large number of children and adolescents in Saudi Arabia, and as a result flash glucose monitoring (FGM) devices are widely used. The factors influencing the effectiveness of FGM are poorly understood in people with T1D.
FGM is more expensive than standard treatment, and there is no guideline for which patients should receive FGM or when they should start FGM. Each hospital in Saudi Arabia has different requirements for starting a diabetic patient on FGM. The effectiveness of FGM can be influenced by many factors, including age, body mass index, type of insulin treatment, duration of diabetes, duration of using FGM, and level of patient engagement.
We investigated the association between glycated hemoglobin (HbA1c) levels after using FGM and potential predictor factors in a population with T1D. The ultimate goal was to help develop national guidelines for those who are eligible to receive funding for FGM, which in turn will enhance the utilization of the device and manage hospital resources, resulting in improved outcomes.
In this retrospective cohort study of 195 T1D patients aged 15 years and above who had used FGM for at least 1 mo, demographic and clinical parameters and related data were extracted from patient records at two hospitals.
FGM in this study resulted in a clinically significant reduction in HbA1c (-0.6 ± 2.1). The uncontrolled group (baseline HbA1c > 9) had the largest reduction in HbA1c levels. There was a statistically significant moderate and negative association between age and level of engagement and HbA1c levels. Patients in the age group of 18-years-old to 45-years-old with a high level of engagement were more likely to demonstrate a large reduction in HbA1c levels. The relationships between HbA1c and other factors varied between no association to weak association.
FGM is a more effective technology for T1D patients over the age of 18 years who are committed to checking their glucose level at least six times a day.
To identify the relationships between HbA1c levels and predictor factors on the long-term use of FGM, a multicenter, prospective, large-scale study on patients with T1D should be conducted in the future.