Early use of continuous glucose monitoring in children and adolescents after total pancreatectomy with islet autotransplantation
Kendall R. McEachron, Neha Potlapalli, Arpana Rayannavar, Elissa M. Downs, Sarah Jane Schwarzenberg, Varvara A. Kirchner, Gregory J. Beilman, Srinath Chinnakotla, Melena D. Bellin
Abstract
BACKGROUND: Children undergoing total pancreatectomy with islet autotransplantation (TPIAT) for chronic pancreatitis require intensive insulin therapy early after TPIAT with narrow glycemic targets, which can a present significant care burden. Outpatient use of continuous glucose monitoring (CGM) systems by children and caregivers early after TPIAT is inadequately studied. METHODS: In this open-label study, we randomized 14 children and adolescents (mean age 15.4 years) after hospital discharge for TPIAT to Dexcom G6 CGM (n = 7) or standard care with a glucometer (n = 7) to assess acceptability and glycemic control with use of CGM versus usual care (glucometer). Participants in the control arm also wore a blinded CGM for 1 week. RESULT: Children randomized to real-time CGM had lower mean sensor glucose values compared with controls (p = 0.002), and high overall satisfaction with CGM. CONCLUSIONS: Our data indicate that CGM is a useful adjunct to diabetes management for children who have recently undergone TPIAT.