Real-time Continuous Glucose Monitoring Outperforms Blood Glucose Meters in Predicting Diabetes Risk Among Children with Acanthosis Nigricans: A Nine-Month Observational Study
DOI:
https://doi.org/10.71637/tnhj.v25i1.961Keywords:
Blood Glucose Self-Monitoring, Child, Diabetes Mellitus, Early Diagnosis, Glucose Monitoring, ContinuousAbstract
Background: The rising prevalence of diabetes mellitus in children necessitates precise glucose monitoring for early detection and intervention. Blood Glucose Meters (BGM) and Continuous Glucose Monitoring (CGM) are widely used, yet their effectiveness in predicting diabetes onset in at-risk paediatric populations remains debated. This study aimed to compare BGM and CGM in predicting diabetes risk among children with Acanthosis Nigricans (AN) and elevated FINDRISC scores.
Methods: A quasi-experimental study was conducted at the Health Polytechnic of the Ministry of Health Sorong over nine months (January–September 2024), involving 76 children aged 10–18 years. Participants were assigned to either the BGM group (measurements every three days) or the CGM group (continuous monitoring every 15 minutes). Key parameters included Time in Range (TIR), mean glucose levels, hypoglycaemia and hyperglycaemia episodes, and adherence rates.
Results: CGM demonstrated superior performance, with a significantly higher TIR (78.9% vs. 63.4%, p<0.001), lower mean glucose levels (145.3 vs. 162.7 mg/dL, p=0.003), and fewer hypoglycaemia (1.1 vs. 2.8, p=0.015) and hyperglycaemia episodes (2.6 vs. 4.5, p=0.002). CGM users also exhibited higher adherence (88.7% vs. 71.3%, p<0.001) and greater accuracy, as indicated by a lower Mean Absolute Relative Difference (MARD) (7.2% vs. 10.8%, p=0.004).
Conclusions: CGM outperforms BGM in predicting diabetes onset in at-risk children, offering improved glycaemic control and adherence. These findings support CGM as the preferred glucose monitoring method for paediatric populations at risk of diabetes.
Downloads
References
1. Tinajero MG, Malik VS. An Update on the Epidemiology of Type 2 Diabetes: A Global Perspective. Endocrinol Metab Clin North Am. 2021;50(3):337-355. doi:10.1016/j.ecl.2021.05.013
2. Perng W, Conway R, Mayer-Davis E, Dabelea D. Youth-Onset Type 2 Diabetes: The Epidemiology of an Awakening Epidemic. Diabetes Care. 2023;46(3):490-499. doi:10.2337/dci22-0046
3. Pramanik S, Mondal S, Palui R, Ray S. Type 2 diabetes in children and adolescents: Exploring the disease heterogeneity and research gaps to optimum management. World Journal of Clinical Pediatrics. 2024;13(2). doi:10.5409/wjcp.v13.i2.91587
4. Antar SA, Ashour NA, Sharaky M, et al. Diabetes mellitus: Classification, mediators, and complications; A gate to identify potential targets for the development of new effective treatments. Biomedicine & Pharmacotherapy. 2023;168:115734. doi:10.1016/j.biopha.2023.115734
5. Chandrasekaran P, Weiskirchen R. The Role of Obesity in Type 2 Diabetes Mellitus—An Overview. International Journal of Molecular Sciences. 2024;25(3):1882. doi:10.3390/ijms25031882
6. Ruze R, Liu T, Zou X, et al. Obesity and type 2 diabetes mellitus: connections in epidemiology, pathogenesis, and treatments. Front Endocrinol. 2023;14. doi:10.3389/fendo.2023.1161521
7. Khan MAB, Hashim MJ, King JK, Govender RD, Mustafa H, Al Kaabi J. Epidemiology of Type 2 Diabetes – Global Burden of Disease and Forecasted Trends. J Epidemiol Glob Health. 2020;10(1):107-111. doi:10.2991/jegh.k.191028.001
8. Ong KL, Stafford LK, McLaughlin SA, et al. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. The Lancet. 2023;402(10397):203-234. doi:10.1016/S0140-6736(23)01301-6
9. American Diabetes Association Professional Practice Committee. 6. Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes—2024. Diabetes Care. 2023;47(Supplement_1):S111-S125. doi:10.2337/dc24-S006
10. Sugandh F, Chandio M, Raveena F, et al. Advances in the Management of Diabetes Mellitus: A Focus on Personalized Medicine. Cureus. 15(8):e43697. doi:10.7759/cureus.43697
11. Jyotsna FNU, Ahmed A, Kumar K, et al. Exploring the Complex Connection Between Diabetes and Cardiovascular Disease: Analyzing Approaches to Mitigate Cardiovascular Risk in Patients With Diabetes. Cureus. 2023;15(8):e43882. doi:10.7759/cureus.43882
12. Xu NY, Nguyen KT, DuBord AY, et al. Diabetes Technology Meeting 2021. J Diabetes Sci Technol. 2022;16(4):1016-1056. doi:10.1177/19322968221090279
13. Huang J, Yeung AM, DuBord AY, et al. Diabetes Technology Meeting 2022. Journal of Diabetes Science and Technology. 2023;17(4):1085. doi:10.1177/19322968221148743
14. Skroce K, Zignoli A, Fontana FY, et al. Real World Interstitial Glucose Profiles of a Large Cohort of Physically Active Men and Women. Sensors. 2024;24(3):744. doi:10.3390/s24030744
15. Almurashi AM, Rodriguez E, Garg SK. Emerging Diabetes Technologies: Continuous Glucose Monitors/Artificial Pancreases. J Indian Inst Sci. 2023;103(1):205-230. doi:10.1007/s41745-022-00348-3
16. Tian T, Aaron RE, Yeung AM, et al. Use of Continuous Glucose Monitors in the Hospital: The Diabetes Technology Society Hospital Meeting Report 2023. J Diabetes Sci Technol. 2023;17(5):1392-1418. doi:10.1177/19322968231186575
17. Yoo JH, Kim JH. Advances in Continuous Glucose Monitoring and Integrated Devices for Management of Diabetes with Insulin-Based Therapy: Improvement in Glycemic Control. Diabetes Metab J. 2023;47(1):27-41. doi:10.4093/dmj.2022.0271
18. Mansour M, Saeed Darweesh M, Soltan A. Wearable devices for glucose monitoring: A review of state-of-the-art technologies and emerging trends. Alexandria Engineering Journal. 2024;89:224-243. doi:10.1016/j.aej.2024.01.021
19. Chobot A, Piona C, Bombaci B, Kamińska-Jackowiak O, Mancioppi V, Passanisi S. Exploring the Continuous Glucose Monitoring in Pediatric Diabetes: Current Practices, Innovative Metrics, and Future Implications. Children. 2024;11(8):907. doi:10.3390/children11080907
20. Klupa T, Czupryniak L, Dzida G, et al. Expanding the Role of Continuous Glucose Monitoring in Modern Diabetes Care Beyond Type 1 Disease. Diabetes Therapy. 2023;14(8):1241. doi:10.1007/s13300-023-01431-3
21. Worth C, Hoskyns L, Salomon-Estebanez M, et al. Continuous glucose monitoring for children with hypoglycaemia: Evidence in 2023. Front Endocrinol. 2023;14. doi:10.3389/fendo.2023.1116864
22. Prasad-Reddy L, Godina A, Chetty A, Isaacs D. Use of Continuous Glucose Monitoring in Older Adults: A Review of Benefits, Challenges and Future Directions. touchREVIEWS in Endocrinology. 2022;18(2):116. doi:10.17925/EE.2022.18.2.116
23. Natale P, Chen S, Chow CK, et al. Patient experiences of continuous glucose monitoring and sensor‐augmented insulin pump therapy for diabetes: A systematic review of qualitative studies. Journal of Diabetes. 2023;15(12):1048. doi:10.1111/1753-0407.13454
24. Rokhman MR, Arifin B, Zulkarnain Z, et al. Translation and performance of the Finnish Diabetes Risk Score for detecting undiagnosed diabetes and dysglycaemia in the Indonesian population. PLOS ONE. 2022;17(7):e0269853. doi:10.1371/journal.pone.0269853
25. Kong SY, Cho MK. Effects of Continuous Glucose Monitoring on Glycemic Control in Type 2 Diabetes: A Systematic Review and Meta-Analysis. Healthcare. 2024;12(5):571. doi:10.3390/healthcare12050571
26. Christiansen MP, Garg SK, Brazg R, et al. Accuracy of a Fourth-Generation Subcutaneous Continuous Glucose Sensor. Diabetes Technology & Therapeutics. 2017;19(8):446. doi:10.1089/dia.2017.0087
27. Guldemond N. What is meant by ‘integrated personalized diabetes management’: A view into the future and what success should look like. Diabetes, Obesity and Metabolism. 2024;26(S1):14-29. doi:10.1111/dom.15476
28. Mittal R, Koutras N, Maya J, Lemos JRN, Hirani K. Blood glucose monitoring devices for type 1 diabetes: a journey from the food and drug administration approval to market availability. Frontiers in Endocrinology. 2024;15:1352302. doi:10.3389/fendo.2024.1352302
29. Mackey ER, Tully C, Rose M, et al. Promoting glycemic control in young children with type 1 diabetes: Results from a pilot intervention for parents. Families, systems & health : the journal of collaborative family healthcare. 2022;40(2):239. doi:10.1037/fsh0000672
30. Miller EM. Using Continuous Glucose Monitoring in Clinical Practice. Clinical Diabetes : A Publication of the American Diabetes Association. 2020;38(5):429. doi:10.2337/cd20-0043
31. Levy CJ, Galindo RJ, Parkin CG, Gillis J, Argento NB. All Children Deserve to Be Safe, Mothers Too: Evidence and Rationale Supporting Continuous Glucose Monitoring Use in Gestational Diabetes Within the Medicaid Population. J Diabetes Sci Technol. 2024;18(5):1198-1207. doi:10.1177/19322968231161317
32. Schierloh U, Aguayo GA, Schritz A, et al. Intermittent Scanning Glucose Monitoring or Predicted Low Suspend Pump Treatment: Does It Impact Time in Glucose Target and Treatment Preference? The QUEST Randomized Crossover Study. Front Endocrinol. 2022;13. doi:10.3389/fendo.2022.870916
33. Schoelwer MJ, DeBoer MD, Breton MD. Use of diabetes technology in children. Diabetologia. 2024;67(10):2075. doi:10.1007/s00125-024-06218-0
34. Moon JS, Kang S, Choi JH, et al. 2023 Clinical Practice Guidelines for Diabetes Management in Korea: Full Version Recommendation of the Korean Diabetes Association. Diabetes Metab J. 2024;48(4):546-708. doi:10.4093/dmj.2024.0249
Published
Issue
Section
License
Copyright (c) 2025 Susanti, C. M. Orizani, R. B. Kristiani, I. Iswati, D. N. Bistara, A. C. Mustamu
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The Journal is owned, published and copyrighted by the Nigerian Medical Association, River state Branch. The copyright of papers published are vested in the journal and the publisher. In line with our open access policy and the Creative Commons Attribution License policy authors are allowed to share their work with an acknowledgement of the work's authorship and initial publication in this journal.
This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission from the publisher or the author.
The use of general descriptive names, trade names, trademarks, and so forth in this publication, even if not specifically identified, does not imply that these names are not protected by the relevant laws and regulations. While the advice and information in this journal are believed to be true and accurate on the date of its going to press, neither the authors, the editors, nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
TNHJ also supports open access archiving of articles published in the journal after three months of publication. Authors are permitted and encouraged to post their work online (e.g, in institutional repositories or on their website) within the stated period, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). All requests for permission for open access archiving outside this period should be sent to the editor via email to editor@tnhjph.com.
