Objective To analyze the condition of out-of-hospital blood glucose control in children with newly diagnosed type 1 diabetes mellitus (T1DM), and to explore the effects of different therapies and monitoring methods for blood glucose on glycosylated hemoglobin (HbA1c).
Methods The clinical materials of children with newly diagnosed T1DM in the Department of Endocrinology, Genetics and Metabolism in the Children's Hospital Affiliated to Kunming Medical University were retrospectively analyzed, and the children were divided into standard group and non-standard group based on the standard of the median HbA1c (7.0%) within 9 months after discharge. According to the way of insulin injection, the children were divided into continuous subcutaneous insulin infusion (CSII) group by insulin pump or multiple daily injection (MDI) group; according to the combinations of therapies and monitoring plans, the children were divided into four groups, including continuous subcutaneous insulin infusion plus instantaneous scanning glucose monitoring group (CSII plus FGMS group), continuous subcutaneous insulin infusion plus self-monitoring blood glucose group (CSII plus SMBG group), multiple subcutaneous insulin injection plus instantaneous scanning glucose monitoring group (MDI plus FGMS group), and multiple insulin subcutaneous injection plus self-monitoring blood glucose group (MDI plus SMBG group). The effects of therapies and monitoring methods for blood glucose on blood glucose control in children with newly diagnosed T1DM were compared.
Results A total of 48 children with newly diagnosed T1DM were included in this study. In the HbA1c standard group (n=15), the children were significantly younger, the usage rates of CSII and FGMS were significantly higher, and the frequency of hypoglycemia was significantly less (P < 0.05); there were no significant differences in gender, living environment, educational level of guardians, body mass index (BMI) and monitoring frequency of blood glucose between two groups (P>0.05). The children in the CSII group were significantly younger, and the reduction effect of HbA1c in the CSII group was significantly better than that in the MDI group (P < 0.05). In the analysis of the therapies combined with monitoring plans, the CSII plus FGMS group showed a significant better rapid reduction of HbA1c amplitude when compared to the MDI plus SMBG group (P < 0.05).
Conclusion The overall blood sugar control status of children with newly diagnosed T1DM is still poor, and the standard rate of blood sugar is low. The use of FGMS within 3 months after discharge in children with newly diagnosed T1DM can help control HbA1c, and continuous 9 months of CSII treatment has a better effect than MDI treatment in rapidly reducing HbA1c. In long-term treatment and monitoring, CSII plus FGMS has a better effect.
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