Impact of continuous glucose monitoring on fear of hypoglycemia and quality of life in children and adolescents with type 1 diabetes

OBJECTIVES: This study aimed to evaluate changes in fear of hypoglycemia (FOH) and quality of life (QoL) following at least six months of continuous glucose monitoring (CGM) use in the same cohort with type 1 diabetes mellitus (T1DM). METHODS: This was a prospective, observational study including first-time CGM users. Auxologic, laboratory, and CGM data was collected. All participants were asked to complete the validated Turkish versions of the Pediatric Quality of Life Inventory (PedsQL) 3.0 Diabetes Module for both children and parents; the quality of life for youth scale for adolescents; children's hypoglycemia index (CHI). RESULTS: When pre- and post-CGM scores were compared, the mean total CHI score significantly decreased (p=0.018). Among the subscales, significant reductions were also observed in the "specific situations" (p=0.044) and "behavior scales" (p=0.025) subscales, whereas the "general fears" did not show a significant change (p=0.396). In PedsQL forms, there were no statistically significant differences between pre- and post-CGM total or subscale scores. CGM metrics were also compared between participants who showed improvement in FOH and/or QoL and those who did not. Participants with improvement in FOH had significantly higher sensor active use percentages compared to those without improvement (98.95 vs. 93.0 %, p=0.039). CONCLUSIONS: This study's ability to assess pre- and post-CGM outcomes in the same patients highlights its clinical significance. Our findings suggest that using CGM in children and adolescents with T1DM is associated with a reduction in FOH.