Minimum Continuous Glucose Monitor Data Required to Assess Glycemic Control in Youth with Type 1 Diabetes.

Abstract

Introduction: Consensus guidelines recommend reviewing 14 days of continuous glucose monitor (CGM) data when assessing glycemia in people with type 1 diabetes (T1D). Adult studies have shown that 7 days of CGM data provide a reliable assessment of glycemia. Objectives: To understand the minimum amount of CGM data required to assess glycemia in the pediatric T1D population. Methods: Real-world Dexcom G6 CGM data were extracted from cloud-based CGM software for 8 time windows (3, 5, 7, 10, 14, 30, 60, and 90 days), all starting on March 1, 2023. Youth <21 years with T1D and ≥70% CGM active time in each window were included. Pearson correlation and interclass correlation coefficients (ICCs) between 14-day data and other windows were calculated. Differences in the percentage of youth within predetermined thresholds of 14-day CGM metrics (±0.3% glucose management indicator [GMI]; ±5% time in range [TIR]/time in tight range; ±1% time below range <70 and <54 mg/dL) were assessed using chi-squared analyses. Sub-analyses were conducted according to categorical groupings of 14-day TIR, coefficient of variation (CV), and age. Results: A total of 1316 youth were included (45.0% female, 76.9% non-Hispanic White, median age 14.6 years). Median 14-day CGM active time was 97.2% and GMI and TIR were 7.4% (7.0, 7.9) and 60.5% (48.6, 70.6), respectively. Pearson correlation coefficients and ICCs between 14-day and GMI and TIR for all 8 windows were >0.9; however, categorical agreement as defined by the percentage of subjects acceptable thresholds for GMI and TIR only exceeded 90% at 10 days. Although there was no difference in agreement for CGM metrics according to categorical groupings of age, agreement was stronger for youth with TIR ≥70% and CV <36%. Conclusions: Although 14 days of CGM data are considered the gold standard, assessing ∼9.6 days of data in youth with T1D provides a reliable assessment of glycemia. For youth with higher TIR (≥70%) and lower CV (<36%), 7-day CGM data may prove sufficient.