Long-term Impact of Continuous Glucose Monitoring Assistance on Glycemic Control in Children and Adolescents with Type 1 Diabetes Following the 2023 Kahramanmaraş Earthquake.

Abstract

Objective: This study aimed to evaluate the impact of continuous glucose monitoring (CGM) assistance on glycemic control in children with type 1 diabetes (T1D) in earthquake-affected regions, comparing those who benefited from CGM with those who did not. Additionally, the study assessed changes in CGM metrics over nine months of CGM use.

Methods: A multicenter, cross-sectional study was conducted across 11 centers in Türkiye. Children with T1D were divided into two groups: those who received CGM support (CGM+) and those who continued with finger-stick glucose monitoring (CGM-). HbA1c levels were measured at four intervals: pre-earthquake, 3-6 months, 6-9 months, and 9-12 months post-earthquake. In the second phase, CGM metrics were analyzed over 90-day intervals in the CGM+ group with at least 85% sensor usage.

Results: A total of 532 children were included. Median HbA1c levels decreased from 9.1% pre-earthquake to 8.8% 3-6 months post-earthquake (p=0.027). In the CGM+ group, HbA1c levels significantly decreased from 8.8% to 8.3% (p<0.001), while no significant change was observed in the CGM- group. Of the 412 subjects with access to CGM reports, 105 (25.4%) had less than 85% sensor usage and were excluded. In the remaining 307 patients, there was a significant increase in active sensor time and daily glucose measurements, along with a reduction in hypoglycemia frequency over the 90-day intervals (p<0.001 for all three).

Conclusion: CGM assistance improved glycemic control in children with T1D, even under the challenging conditions of the earthquake. These findings highlight the need for broader access to CGM devices to enhance diabetes management.