Pediatric endocrinologist Benjamin Nwosu, MD, led a UMass Medical School study which found that teens with type 1 diabetes whose glucose levels were continuously monitored were able to improve control of their blood sugar—which can be uncontrollably elevated during adolescence due to a phenomenon called physiologic hyperglycemia of puberty (PHOP).
“The goal of our study was to determine if continuous glucose monitoring helps pubertal youth with T1D improve glycemic control compared to teens without continuous monitoring,” said Dr. Nwosu, professor of pediatrics. “Our hypothesis was that consistent continuous glucose monitor use in puberty improves compliance with diabetes management leading to better short- and long-term blood sugar levels.”
Published in the Journal of Pediatric Endocrinology and Metabolism, the study analyzed blood glucose data from the Children’s Medical Center database of 105 pediatric T1D patients at UMMS clinical partner UMass Memorial Medical Center. The 54 youth in the continuous glucose monitor group showed evidence of consistent use more than 80 percent of the time for at least a year, with recent improvements in the technology leading to more clinicians and families adopting it.
A1c test results, which reflect average blood sugar level for the past two to three months, were significantly lower in the continuous glucose monitor group after 12 months. The analysis also showed that continuous glucose monitor users had no change in A1c from a young age through puberty and older, whereas those who did not use a continuous monitor experienced an increase in A1c with increasing age and pubertal status.
Prior studies of both children and adults that reported improved blood glucose outcomes in patients using continuous monitoring did not fully examine its effect on physiologic hyperglycemia of puberty.
“It’s encouraging to see data showing improved glycemic control and lower A1c during the phase of persistent hyperglycemia of puberty in what is traditionally a noncompliant population,” said Nwosu. “This real-time, glucose-data driven approach to diabetes management could provide the basis for a well-calibrated insulin dosing regimen to reduce insulin resistance and reduce the magnitude of insulin resistance-mediated PHOP.”